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Inspection on 11/05/05 for Flower Park Nursing Home

Also see our care home review for Flower Park Nursing Home for more information

This inspection was carried out on 11th May 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The staff team work very well together providing good quality care for the service users. Many service users commented that the staff were excellent, worked very hard and all worked together helping each other. The standard of cleanliness throughout the home was excellent with many service users and visitors commenting on the high standards of cleanliness. The meals were wholesome, nutritious and appealing service users stated they were always very good.

What has improved since the last inspection?

The care plans have been reviewed and updated since the last inspection and cover the needs of the service users in order that staff are able to understand the needs and provide appropriate care. The upstairs unit, which has service users with dementia and mental health problems, now has an appropriately trained unit manager. There have been major improvements on this unit as it was many months without a manager. The mental health needs of the service users are now being met. Many reviews have been carried out including medication, care plans and social work assessments.

What the care home could do better:

The home does not meet the needs of the service users in regard to leisure, social activities and interests. The home only provides 9 hours for an activities co-ordinator, which from feedback received from staff, relatives and service users, is inadequate. The staff training was poor most mandatory training was either out of date or staff had never attended. Inappropriate moving and handling techniques were witnessed during the inspection, which could put service users at potential risk of harm.

CARE HOMES FOR OLDER PEOPLE FLOWER PARK NURSING HOME Flower Park Rossington Street Denaby Doncaster South Yorkshire DN12 4BT Lead Inspector Sarah Powell Unnanounced 11 May 2005 06.30. 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. FLOWER PARK NURSING HOME J55-J07 S15860 Flower Park Nursing Home V215403 110505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Flower Park Nursing Home Address Flower Park, Rossington Street, Denaby, Doncaster, South Yorkshire, DN12 4BT 01709 863327 01709 860303 flower.park@fshc.co.uk Four Seasons Healthcare (England) Limited 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) Alison Commins Care Home with Nursing 40 (24) (24) (16) Category(ies) of DE(E) Dementia over 65 years registration, with number MD(E) Mental Disorder over 65 of places OP Old Age FLOWER PARK NURSING HOME J55-J07 S15860 Flower Park Nursing Home V215403 110505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 9th March 2005 Brief Description of the Service: Flower Park is a purpose built home situated in Denaby near Doncaster it is set in a residential area with shops, a market and other amenities nearby. The home is on two floors the upper floor is for service users with dementia and mental disorder over 65 years and has lift access, the ground floor accommodates nursing service users over 65 years. Flower Park can accommodate up to forty service users. All rooms are single and the majority are en-suite with toilet and wash hand basin.The home has a suitable number of lounges, dining rooms, toilet and bathing facilities. The gardens are well maintained and easily accessible to the service users on the ground floor, access is limited for the service users on the first floor. FLOWER PARK NURSING HOME J55-J07 S15860 Flower Park Nursing Home V215403 110505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes first inspection in the year 2005/2006 and took place over one day the inspection commenced at 06.30 and finished at 15.00. The previous requirements were looked at with the manager. 22 Service users, 11 staff and 7 representatives were spoken to. The hairdresser that visits the home weekly was also spoken to. A tour of the building took place staff and practices were observed including moving and handling, serving lunch, staff interacting with service users, visitors and other staff members. What the service does well: What has improved since the last inspection? The care plans have been reviewed and updated since the last inspection and cover the needs of the service users in order that staff are able to understand the needs and provide appropriate care. The upstairs unit, which has service users with dementia and mental health problems, now has an appropriately trained unit manager. There have been major improvements on this unit as it was many months without a manager. The mental health needs of the service users are now being met. Many reviews have been carried out including medication, care plans and social work assessments. FLOWER PARK NURSING HOME J55-J07 S15860 Flower Park Nursing Home V215403 110505 Stage 4.doc Version 1.30 Page 6 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. FLOWER PARK NURSING HOME J55-J07 S15860 Flower Park Nursing Home V215403 110505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection FLOWER PARK NURSING HOME J55-J07 S15860 Flower Park Nursing Home V215403 110505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3 and 4 The statement of purpose and service users guide had been updated and enabled service users to have the information they required. Four Seasons have still to provide any service user with a written contract and statement of terms and conditions. Service users are unable to determine what overall care and services are covered by the fees and have no written confirmation that they are able to reside at the home making them feel vulnerable. Assessments are carried out on all service users but the home was unable to demonstrate that they were able to meet the needs of all service users. EVIDENCE: The statement of purpose and service users guide had been updated by the manager since the last inspection has this had been a previous requirement. These now contained all the required information for service users. FLOWER PARK NURSING HOME J55-J07 S15860 Flower Park Nursing Home V215403 110505 Stage 4.doc Version 1.30 Page 9 New service users are only admitted following a full assessment these were seen in the plans of care and the new service users assessments were very good and a major improvement on the previous assessments enabling staff to meet the needs of the service users, although service users needs were not always met as staff hours had been reduced and if sickness occurred the staff stated they were very stretched and could not care for service users appropriately. Staff had the experience to deliver the service and care but did not have up to date training providing the necessary skills, so were not always able to provide the appropriate service and care to service users. FLOWER PARK NURSING HOME J55-J07 S15860 Flower Park Nursing Home V215403 110505 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 and 10 Care plans had been reviewed and updated since the last inspection and service users said they were treated with respect and dignity. EVIDENCE: The new unit manager on the upstairs unit had reviewed the plans of care as this had been a previous requirement and they provided the basis for the care to be delivered to ensure service users needs were met. All service users had risk assessments however some were very limited in detail and could put service users at risk they need more detail for staff to understand the potential risk and safeguard the service users from harm. Privacy and dignity were shown to service users this was seen during the inspection and the service users spoken to all commented that staff were lovely, caring and always respected them and maintained their dignity. FLOWER PARK NURSING HOME J55-J07 S15860 Flower Park Nursing Home V215403 110505 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15 Service users did not have their leisure, social and recreational interests met. Service users receive a wholesome balanced diet. EVIDENCE: The home employs an activities co-ordinator for 9 hours a week the service users said “she is wonderful but does not work enough hours” the 9 hours provided is not enough to meet 40 service users leisure, social and recreational interests. Staff stated they do not have the time to meet care needs as well as social needs as their hours have been reduced. The service users commented that the care staff tried very had to entertain them when the activities coordinator was not working but it was usually impossible as they were very busy. The comments from relatives were very similar and many said “there is a lack of stimulation especially on the upstairs unit, a karaoke night is organised once a month and the service users on the upstairs unit really enjoy this and it is a pity this can not be provided more often”. The diet provided is wholesome and nutritious service users said, “the food is lovely”. There was a menu which was changed regularly a choice was available at every meal. Two service users husband regularly stopped for lunch as they spent all day with their wives this was encouraged and much appreciated by the men one commented staff are wonderful and support me as well as my wife. FLOWER PARK NURSING HOME J55-J07 S15860 Flower Park Nursing Home V215403 110505 Stage 4.doc Version 1.30 Page 12 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) 18 Service users are protected from abuse. EVIDENCE: The home has an adult protection policy and procedure all staff were aware of this and knew what to do if they needed to report an incident, in order to protect the service users. The staff training in protection of vulnerable adults had not been carried out; this needs to be addressed in order that staff are aware of all types of abuse in order to protect service users. FLOWER PARK NURSING HOME J55-J07 S15860 Flower Park Nursing Home V215403 110505 Stage 4.doc Version 1.30 Page 13 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, 20,24 and 26 Service users live in a safe, well maintained environment and the standard of cleanliness is excellent. The home does not have a sluicing disinfector. EVIDENCE: The standard of the environment and cleanliness observed during the tour of the home was excellent. Service users bedrooms are personalised and furnished and equipped to assure comfort for the service user. There is a rolling programme of routine maintenance, providing a safe environment for the service users. Service users said, “The home is always very clean and well maintained”. The gardens were well maintained and easily accessible to all service users. During the tour of the building it was noted that the home did not provide a sluicing disinfector. FLOWER PARK NURSING HOME J55-J07 S15860 Flower Park Nursing Home V215403 110505 Stage 4.doc Version 1.30 Page 14 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, 28 and 30 Not all service users needs are met by the numbers of staff, training is poor, staff are not receiving mandatory training. EVIDENCE: NVQ training for staff is ongoing and the home hopes to achieve 50 qualified to level 2 to meet the previous recommendation. The staff training files were looked at and it was evident Staff were not receiving mandatory training some staff that had worked at the home for many years had never attended some of the mandatory training putting service users and staff at risk. The manager is aware this needs to be addressed as it was a previous requirement and dates were organised before the inspection was finished. It was observed during the inspection that some staff demonstrated bad practices when moving and handling the service users putting them at risk of potential injury, although this was one area of training that all staff had attended so it was either not appropriate or being ignored this needs to be addressed to protect service users from harm. The staffing number can meet the basic needs of the service users including daily living needs but it is not meeting their social and emotional needs. Staff confirmed that they are very busy with the numbers on duty and if sickness occurs it is impossible to meet the basic needs and there are no additional staff on duty at peak times to meet service users needs. FLOWER PARK NURSING HOME J55-J07 S15860 Flower Park Nursing Home V215403 110505 Stage 4.doc Version 1.30 Page 15 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) 31 and 38 The manager is a registered nurse with many years experience and the health and safety of service users is promoted. EVIDENCE: The Manager is currently finishing her Registered Managers Award, which was a previous requirement. The Manager is now supported by a unit manager on the upstairs unit who is a Registered Nurse (mental Health), therefore service users with a mental illness are having their needs met. The home has a comprehensive health and safety policy to safeguard service users, staff and all visitors, however safe working practices were not always followed due to lack of staff training putting service users at potential risk. Bad practices were observed during the inspection for example no foot plates used on wheelchairs and not using lifting aids for service users. The manager addressed the footplates during the inspection and they were all fitted back in place by the maintenance man to ensure the safety of the service users. FLOWER PARK NURSING HOME J55-J07 S15860 Flower Park Nursing Home V215403 110505 Stage 4.doc Version 1.30 Page 16 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 3 1 3 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 x x 3 3 x 2 STAFFING Standard No Score 27 2 28 2 29 x 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 3 x x x x x x 2 FLOWER PARK NURSING HOME J55-J07 S15860 Flower Park Nursing Home V215403 110505 Stage 4.doc Version 1.30 Page 17 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 OP2 Regulation 5 Requirement The registered provider must ensure all service users are issued with a contract. (previous timescale not expired of 1 June 2005) Service users must have risk assessments carrried out to ensure the safety and wellbeing of staff and service users is not potentially put at risk. Ensure social, cultural, religious and recreational needs of service users are met. (old timescale of 1 June 2005 not yet expired). Ensure all staff attend training on protection of vulnerable adults. The home should provide a sluicing disinfector. Ensure the numbers and skill mix of staff on duty meet all the service users needs. Ensure all staff attend mandatory training to ensure the safety of the service users. Make suitable arrangements to provide a safe system for moving and handling service users. Ensure the footplates are used on the wheelchairs at all times. J55-J07 S15860 Flower Park Nursing Home V215403 110505 Stage 4.doc Timescale for action 1.6.05 2. OP7 13 1.7.05 3. OP12 16 1.6.05 4. 5. 6. 7. 8. 9. OP18 OP26 OP27 OP30 OP38 OP38 18 13 18 18 13 12 1.8.05 1.8.05 1.7.05 1.8.05 1.8.05 immediate FLOWER PARK NURSING HOME Version 1.30 Page 18 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 Op28 Good Practice Recommendations Ensure 50 of care staff NVQ level 2 by 2005. FLOWER PARK NURSING HOME J55-J07 S15860 Flower Park Nursing Home V215403 110505 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection First Floor Barclay Court Heavens Walk Doncaster South Yorkshire DN4 5HZ 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 FLOWER PARK NURSING HOME J55-J07 S15860 Flower Park Nursing Home V215403 110505 Stage 4.doc Version 1.30 Page 20 - 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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