Inspection on 19/04/05 for Euxton Park Care Home

This inspection was carried out on 19th April 2005.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Euxton Park Care Home 19/08/08

Euxton Park Care Home 31/10/07

Euxton Park Care Home 23/05/06

Euxton Park Care Home 15/11/05

Euxton Park Care Home 09/11/04

Euxton Park Care Home 24/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Euxton Park Care Home Wigan Road Euxton Chorley, Lancashire PR7 6DY Lead Inspector Anne Taylor Unannounced 19 April 2005 10:00 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 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. Euxton Park Care Home F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Euxton Park Care Home Address Wigan Road Euxton Chorley Lancashire PR7 6DY 01257 230022 01257 230385 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Tamaris Healthcare N/A Care Home 63 Category(ies) of OP - Old Age registration, with number PD - Physical Disability of places TI - Terminally Ill Euxton Park Care Home F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to 42 older persons (OP) needing personal care only. 2. Up to 2 younger adults with a physical disability (PD). 3. Up to 2 persons needing palliative car (TI). 4. The service should, at all times, employ a suitably qualified and experienced manager who is registered with the National Care Standards Commission. Date of last inspection 9th November 2004 Brief Description of the Service: Euxton Park is situated on the edge of Chorley, in the village of Euxton. The home is within easy reach of the towns of Chorley and Leyland. The home is purpose built and can accommmodate sixty-three people of either sex with either nursing or personal care needs. Of the sixty-three places two beds may be used for people with physical disabilities and two places for people who require care associated with a terminal illness, the remainder of places are for older people. At the time of inspection fifty-five peole were living at the home. Thirty-four were receiving personal care and twenty-one receiving nursing care. Accommodation is provided over two floors, served by a pasenger lift. Each floor has communal lounges, dining room and access to a kitchen. All the rooms are single, although some larger rooms are available should anyone wish to share. Euxton Park is set in extensive, well maintained grounds with seating areas to the front and rear of the home that can be used by people living at or visiting the home. Euxton Park Care Home F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over two days in April 2005 by two regulation inspectors. The inspection involved discussion with the people who lived and worked at the home, examination of records, policies and procedures and a tour of the premises. As part of the inspection process the inspectors used “case tracking” as a means of assessing some of the National Minimum Standards. This process allows the inspector to focus on a small group of people living at the home. All records relating to these people are inspected along with the rooms they occupy in the home. They are invited to discuss their experience of the home with the inspector, however this is not to the exclusion of other people living at the home. Since the last inspection there have been two complaints investigated by the Commission for Social Care Inspection. The home took action to resolve the areas of concern. What the service does well: What has improved since the last inspection? Euxton Park Care Home F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 6 The environment had been improved and previous concerns about the standard of cleanliness addressed. A significant number of bedrooms had been redecorated and refurbished. New carpets had been fitted in corridors and the reception area of the home. Residents had been provided with a lockable facility for the safe keeping of valuables and personal possessions. Additional adjustable beds had been provided for those requiring a high level of nursing care so that any clinical or medical procedures could be interventions could be managed more easily and residents made more comfortable. Thermostatic valves had been fitted to a number of washbasins and baths to ensure that hot water was being delivered at safe temperatures and the risk of scalding reduced. Staff morale was better and people who lived and worked at Euxton Park had benefited from the management and leadership skills of the new manager. What they could do better: The pre admission assessment process could be improved by developing the assessment form used by the home and ensuring people coming to live at the home or their representative are consulted. Care plans in general, including some risk assessments need to be improved to ensure individual needs and instructions for staff are clear and specific. Improved practice regarding the safe handling of medication could be achieved by making sure all records relating to the receipt of medicines received into the home for people who live there are accurate and up to date. The limited programme of activities could be improved by developing a programme of social, recreational and leisure activities that provides people who live at the home with additional stimulation and allows those who choose to participate to have the opportunity to plan their days in an organised manner. Please contact the provider for advice of actions taken in response to this Euxton Park Care Home F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Euxton Park Care Home F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Euxton Park Care Home F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 5. The admission process was clear so that people living at the home could be sure that their needs had been properly assessed and they could make an informed choice about the suitability of the home. EVIDENCE: An assessment of health, personal care and social needs had been carried out for residents before they came to live at the home. The assessments had been completed by social services and the home. Further work is needed on the assessment tool used by the home if it is to be used in isolation and the home needs to show that residents have been involved in their assessment process. The manager confirmed that she or another trained nurse carried out the assessments undertaken by the home. People living at the home said things like, “my daughter came to look at the home before I came, she chose it” and “I visited the home with my family before I came to live here”. Euxton Park Care Home F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 and 10. The care planning process was not thorough enough to ensure that individual needs were consistently met. Risk assessments were not detailed enough to ensure the safety of residents. EVIDENCE: The care plan format generalised care needs and instructions for staff to follow had not always been made specific to the individual. One care plan seen had not been fully completed and did not include instructions for staff about pain management and dressings. Despite this, care staff knew about the people they cared for, were able to discuss individual needs and made every effort to ensure the needs of the people they cared for were met. The manager said that staff had up to two weeks to complete care plans. This is too long, records should be written as soon as possible after admission so that current information on the care and condition of the resident is provided. People living at the home had not been involved in the compilation of their care plans and when asked did not know what a care plan was. They also said that they were not interested because “if you tell them, (the staff), they see to it”. Euxton Park Care Home F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 11 Records showed that people living at the home had access to health care services according to individual need. Risk assessments were in place although further work was needed regarding the use of bed rails. People living at the home were comfortable and well cared for. They were appropriately dressed and attention paid to personal hygiene needs and pressure area care. Residents spoken to say, “the care is very good here, they, (the staff) are very nice and help if they can”. Systems were in place to support people living at the home to administer their own medication if they chose. Records relating to the administration of medication were generally satisfactory although records relating to the correct receipt of medicines brought into the home need improving. People living at the home say staff maintained their dignity and treated them respectfully. They commented, “staff always knock before they come in my room” and “they shut the door while they wash and dress me”. Euxton Park Care Home F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15. The daily routines were flexible so that residents were able to exercise choice, and have some control over their lifestyle. People living at the home received support from staff so that their cultural and religious needs could as far as possible be met. The range of social activities available was limited so that the expectations of people living at the home in relation to this were not fully satisfied. EVIDENCE: People living at Euxton Park were satisfied with the lifestyle they experienced. They said, “I am treated like a Queen”, and “It is like a four star hotel”. There was no planned programme of activities and no one was specifically employed to organise and provide recreational and social activities. Some of the people spoken to preferred to spend time in their rooms, and were happy that they were not forced to participate in the activities provided, others felt that there was a tendency to get bored as “there isn’t enough going on”. Spiritual support for people living at Euxton Park was available if they wanted it. Staff facilitated access to local clergy of various denominations and helped residents to attend religious services. Euxton Park Care Home F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 13 Contact with family and friends was encouraged. The home provided written information about visiting and made efforts to ensure visitors were made to feel welcome. Bedrooms were clean and homely. Many were filled with personal possessions. People living at the home were generally pleased with their private accommodation and said, “I have a lovely room and a lovely view” and “yes, it’s nice and I’ve made it my own”. A record of personal items brought into the home should be kept. Four weekly menus showed that a well balanced diet was provided. The menus were not displayed and did not always correspond to the meal being served. This meant that people living at the home did not always know what food would be served. Some residents said that they could have anything they wanted to eat and thought the food was good. The chef was fully aware of dietary needs and was prepared to accommodate individual choices. Hot beverages were served in between meals, although people living at the home said that these were often tepid. Staff provided assistance at meal times, although independent eating was also encouraged. Euxton Park Care Home F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The standards relating to complaints and protection were not assessed at this inspection. EVIDENCE: Euxton Park Care Home F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 15 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 standard(s) 19, 24, 25, 26. The home provided those living there with a well maintained, comfortable and homely environment. Security measures were in place so that residents could be assured that they and their personal property would be safe. EVIDENCE: People living at the home were satisfied with the environment they lived in. They said, “This is a lovely, clean home” Although a written programme of routine maintenance was not in place a rolling programme of redecoration and refurbishment was evident. Additional adjustable beds had recently been provided for those people needing a high level of nursing care so that any clinical interventions could be more easily managed. New carpets had been fitted in the corridors and reception area. Ten bedrooms had been refurbished and redecorated, providing service users with pleasant private surroundings. Euxton Park Care Home F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 16 Bedrooms were well furnished and comfortable. People living at the home or their representative were given the opportunity to choose the colour scheme for their bedroom when the room needed redecorating. Bedrooms were safe and secure, radiator guards had been fitted, window restrictors in place and hot water delivered at a safe temperature. People living at the home had a lockable facility in their bedroom for the safe keeping of valuables and money. Some bedrooms also had locks fitted to the doors and plans were in place to ensure all rooms had a lock. A key was provided for people that wished to have one. Laundry facilities were adequate for the size of the home and infection control measures in place that were understood and adhered to by staff. People living at the home say, “my clothes come back washed and ironed, staff put them away for me” The plastic coating had come off the clothes dryer in places and should be replaced. The registered person should be able to demonstrate that the premises are compliant with the Water Supply (Water Fittings) Regulations 1999. Euxton Park Care Home F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29. The recruitment process was not thorough enough to ensure the continued protection of residents. The skill mix of and the number of staff on duty was sufficient to ensure the needs of residents were met. EVIDENCE: Staff rotas were in place, which showed the number of staff on duty and the capacity in which they were employed. Head office instructed the manager as to the number of staff that should be on duty at any given time and staffing levels were in accordance with the minimum requirements of the previous regulatory bodies. However, the dependency needs of people living at the home should be reviewed and evaluated regularly and staffing levels determined accordingly. People living at the home said about the staff “they look after me well and ”they are very obliging and help me when I need it”. Staff records showed that in general a robust recruitment procedure was in place and a Criminal Record Bureau check had been obtained for each employee. However, all references and verification of registration in respect of qualified nurses must be obtained prior to the start of employment. Euxton Park Care Home F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35, and 38 The home was well managed. Adminstration procedures were sound and protected the financial interests of people living at the home. Health and safety issues were appropriately managed, thus providing a safe environment for people that lived and worked at the home. EVIDENCE: The administrator operated a safe system for handling personal allowances. Records seen in relation to this were accurate and up to date. Residents spoken to confirmed that they had access to any personal monies handled by the home on their behalf. Euxton Park Care Home F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 19 Discussion with the manager and staff demonstrated a clear commitment to health and safety issues and a number safe working practices were verified at the time of inspection. People living at the home say, “This is a good home and I feel safe here”, “if I want shopping or anything I just have to ask, and I get a receipt”. Records examined demonstrated that induction training included information relating to safe working practices. Staff said that they had received a lot of training recently including fire safety and moving and handling. Certificates were inspected which confirmed that regular servicing had taken place in relation to systems and equipment utilised the home. A copy of the electrical installation certificate must be submitted to the Commission, as the manager was unable to find it at the time of inspection. Euxton Park Care Home F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION 3 x x x x 2 2 2 STAFFING Standard No Score 27 2 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x 3 x x 2 Euxton Park Care Home F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 21 YES 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 3 Regulation 14(1) Requirement The pre admission assessment undertaken by the home must contain more detail so that needs are clearly identified. People coming to live at the home or their representative must be given the opportunity to be involved in the assessment. (Timescale of 28th February 2005 not met) 2. 7 Care plans must be specific to 31.07.05 the individual and contain clear instructions for staff as to how identified needs are to be met. Plans must be completed as soon as possible after admission. 15(1) People living at the home or 31.07.05 their representative must be given the opportunity to be involved in the development and review of care plans. (Timescale of 31st January 2005 not met) 13(4) The risks associated with the use 30.06.05 of bed rails must be properly assessed and appropriately documented. (Timescale of 31st January 2005 not met) Schedule All medication received into the 30.06.05 3 17(1)(a) home on behalf of service users F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 22 Timescale for action 30.06.05 15(1) 3. 7 4. 8 5. 9 Euxton Park Care Home must be correctly receipted 6. 12 16(2)(m) (n) Service users must be consulted 30.06.05 about the programme of activities available to them at the home. (Timescale of 31st March 2005 not met). The fitting of radiator guards 31.08.05 must be extended to include all areas where service users have access. (Timescale of 31st March 2005 not met). 31.05.05 Written references for prospective employees must be obtained prior to the commencement of employment. (Timescale of 31st January 2005 not met). The registered person must verify that qualified nurses hold a current registration with the Nursing and Midwifery Council. A copy of the electrical installation certificate must be submitted to the Commission. 7. 25 13(4)(a) (c) 8. 29 19 Schedule 2 9. 10. 38 23(2)(b) 30.04.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 7 8 12 Good Practice Recommendations An alternative to standardised care plans should be considered or more stringent monitoring introduced. Trained nurses should ensure that they follow the guidelines issued by the Nursing and Midwifery Council in relation to records and record keeping. Up to date information about activities should be circulated to all service users in formats suited to their capacities. It is recommended that consideration be given to the appointment of an activities co-ordinator and the development of a planned programme of recreational and social activities. F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 23 Euxton Park Care Home 4. 5. 14 15 6. 7. 8. 24 26 27 An audit of service users belongings brought into the home should be implemented to aid in the protecton of service users personal possessions. The menu should be displayed within the home in a format suitable for residents to read and this menu should correspond with the meal being served. Beverages served should be of an acceptable temperature. All bedroom doors be fitted with locks of a type that can be accessed by staff in an emergency. Residents should be offered a key unless a risk assessment suggests otherwise. The registered person should be able to demonstrate that the premises is compliant with the Water supply (Water Fittings) Regulations 1999. Dependency levels of people living at the home should be reviewed and evaluated regularly and staffing levels determined accordingly. Euxton Park Care Home F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Levens House Ackhurst Business Park Foxhole Road Chorley PR7 1NW 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 Euxton Park Care Home F57 F08 S25559 Euxton Park V222698 190405 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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