Inspection on 09/10/07 for Flower Park Nursing Home

This inspection was carried out on 9th October 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Flower Park Nursing Home 01/05/07

Flower Park Nursing Home 07/11/06

Flower Park Nursing Home 08/06/06

Flower Park Nursing Home 13/10/05

Flower Park Nursing Home 11/05/05

Flower Park Nursing Home 09/03/05

Flower Park Nursing Home 19/10/04

Flower Park Nursing Home 15/12/03

Flower Park Nursing Home 20/05/03

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

CARE HOMES FOR OLDER PEOPLE Flower Park Nursing Home Rossington Street Denaby Doncaster South Yorkshire DN12 4BT Lead Inspector Sarah Powell Key Unannounced Inspection 9th and 11th October 2007 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000015860.V350511.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 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. DS0000015860.V350511.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Flower Park Nursing Home Address Rossington Street Denaby Doncaster South Yorkshire DN12 4BT 01709 863327 01709 860303 flower.park@fshc.co.uk www.fshc.co.uk Four Seasons Health Care (England) Limited (wholly owned subsidiary of Four Seasons Health Care Ltd) Post Vacant Care Home 40 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) Category(ies) of Dementia - over 65 years of age (24), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (24), Old age, not falling within any other category (16) DS0000015860.V350511.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The service may admit up to four persons between the age of 60 to 65 years within the category of Dementia (DE) and Mental Disorder (MD). One specific service user under the age of 65 (Mental Disorder), named on variation dated 22nd August 2006, may reside at the home. One specific service user under the age of 65 (Mental Disorder), named on variation dated 9th November 2006 may reside at the home. 1st May 2007 Date of last inspection 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 years and has lift access, the ground floor accommodates nursing service users, 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. The fees at Flower Park Care Home at the time of the inspection ranged from £343.00 - £477.05 free nursing care. For further clarification please contact the home. DS0000015860.V350511.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit, which occurred on 9th and 11th October 2007 over 13 hours commencing at 10:30 on the first day and ending at 15:15 hours. The second day commenced at 09:15 and finished at 17:00 hours. On the first day as part of the visit we spent 2 hours in the lounge watching what was happening. This showed what life was like for people using the service. The visit also included talking with people living at the home, a number of relatives, the manager and nine staff. A walk round the building occurred and some records were checked Some surveys forms were sent to people who live at the home and their relatives. At the time of this visit five were completed and returned to the Commission. The comments received were very positive. The manager completed an annual quality assurance assessment (AQAA) and returned this prior to the visit this focuses on how well outcomes are being met for the people using the service. It also gives us some numerical information about the service. What the service does well: What has improved since the last inspection? A new manager had been in post for four months and the home had made good improvements, which improved the care and wellbeing of the people who lived in the home. People now had an individual plan of care which identified and met their needs. The new manager had carried out a survey on the meals and had instigated change on people’s requests. People said “the meals are really nice and there is always a choice”. DS0000015860.V350511.R01.S.doc Version 5.2 Page 6 The home had recently had a food safety inspection by Doncaster Council and had received a four star rating. Environmental standards had improved, the two shower rooms had been completely refurbished enabling people to have a choice of washing facilities to meet their needs. All staff were trained to be able to meet the needs of the people who lived at the home. Medication procedures had been completely reviewed and new policies and procedures put in place to safeguard the people. 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. DS0000015860.V350511.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000015860.V350511.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 and 6. People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All people in the home had their needs assessed prior to moving into the home to ensure these could be met. EVIDENCE: Some records seen showed that pre admission assessments had occurred and contracts provided. Suitably qualified nurses carried out the pre admission assessments. The assessments were very detailed with all needs identified ensuring that the home could meet their needs before a place was offered to the person. Every person in the home had a contract and terms and conditions issued at the time of moving in. These were very detailed and explained what would be provided while the person lived at the home. The home does not provide intermediate care. DS0000015860.V350511.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person in the home had a plan of care with clearly identified needs, ensuring these were met, by the home. Medication procedures protect the people living in the home and people were treated with respect. EVIDENCE: The new manager and staff had over the last few months re-written all the plans of care as previously these had been very poor. Three people in the home were case tracked and their plans were looked at in detail. The plans had identified the needs of the people with good recordings of the measures to take to meet the needs. The plans were regularly reviewed and people and their relatives were involved in this process ensuring their views were listened to. People spoken to were aware of the plans and confirmed they had had input into them if they wished. DS0000015860.V350511.R01.S.doc Version 5.2 Page 10 All health care needs were met regular input from health care professionals were obtained. Their advice was followed and well documented in the plans ensuring the wellbeing of the people who loved in the home. A Community Psychiatric Nurse who was part of the home care liaison team was in the home on the day we visited, she said “The new manager has made great improvements in the home and the care of the people in the home, the care plans reflect the needs of the people and are excellent”. Medication policies safeguard the people who lived at Flower Park. The procedures had been much improved since the last visit and all the requirements and recommendations had been met ensuring the people who live at the home were protected. People who lived at Flower Park were treated with respect and privacy and dignity upheld. During the two hour observation in the lounge staff were observed interacting well with people and their relatives and people were positive showing a good state of wellbeing. People said “the staff are lovely they look after us very well”. DS0000015860.V350511.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was good family contact, people exercised choice and control over their lives ensuring their needs were met. EVIDENCE: The home employed an activities co-ordinator 30 hours a week. Activities were arranged taking into consideration people’s choices and abilities meeting their social, cultural and recreational needs. Outside entertainers were also arranged and outings. People said that they enjoyed the entertainment it was a good social occasion. At the time of the visit a 100th birthday party was taking place all the person’s family had been invited and a buffet was provided. There was a lively party atmosphere, which was enjoyed by all. Relatives and friends visit at any time and were always made welcome. Relatives said the staff are always polite and welcoming when they visit. One said “I am always made welcome and offered a drink”. DS0000015860.V350511.R01.S.doc Version 5.2 Page 12 People in the home were offered choices this was observed during the twohour observation staff always gave choices and respected peoples decisions ensuring their needs were met. The manager had recently carried out a survey concentrating on the meals gaining the views of the people who lived in the home. Following this survey some changes had been made to the meals to meet peoples needs. The people in the home said “The meals are very good and the choice has much improved”. DS0000015860.V350511.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who lived in the home were listed to and protected. EVIDENCE: The home had a comprehensive complaints procedure, which was clearly displayed, in the entrance hall. All people we spoke to were aware of the procedure but staid, “If we had a concern, or complaint we would speak to the manager, or staff as they are always approachable and listen to us”. The manager had received a number of concerns which had all been resolved, good records were kept of outcomes. This showed they had been fully investigated, acted on and taken seriously The home in the past has had a number of adult safeguarding referrals which are still being dealt with by Doncaster council’s adult protection unit. The home had an embargo placed on admissions last year this was removed in July 2007 following improvements in the home by the new management team. The home has had no further adult safeguarding incidents this year and the new manager, had put better safeguards in place to protect the people in the home. The staff had all received further training in adult protection and were DS0000015860.V350511.R01.S.doc Version 5.2 Page 14 aware of the procedures to follow should an alleged incident occur, ensuring people were protected. DS0000015860.V350511.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was well maintained clean, pleasant and comfortable ensuring people lived in a safe environment. EVIDENCE: The environmental standards throughout the home had much improved. It provided a homely and welcoming home, which was maintained to an excellent standard of cleanliness. Ensuring a safe, well maintained environment for the people who lived there. There was a slight odour on the upstairs corridor, the manager had identified the cause and had submitted a request for a new floor covering to alleviate the problem . DS0000015860.V350511.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff were appropriately trained, the recruitment procedures were robust ensuring people were in safe hands at all times and were protected. EVIDENCE: The home was split into two units, there was a qualified nurse on each unit, 24 hours a day to meet peoples needs. Care staff numbers are determined by the number and needs of the people on each unit and appropriate levels were maintained on the day we visited ensuring peoples needs were met. During the two hour observation on the upstairs unit we observed that the staff were stretched at peak times, i.e. during the lunchtime meal. This was discussed with the manager and she agreed it was busy at times. She was also aware that if another person was to come to live on the upstairs unit or the needs of the existing people increased a further carer would be needed, she assured us that this would be increased to meet peoples needs when required. The new manager was addressing NVQ training for care staff and had a number enrolled on the training and was working towards 50 of care staff trained to NVQ level 2 or above, to ensure people are in safe hands at all times. DS0000015860.V350511.R01.S.doc Version 5.2 Page 17 We saw two staff files these contained all the relevant information, staff were only appointed following a successful criminal record check to safeguard the people in the home. Mandatory training for all staff was up to date and the home had an ongoing training programme so all new starters were trained on commencement of employment, ensuring the staff were competent to do their jobs. The training files were not kept up to date and were unorganised therefore finding evidence that training had been carried out difficult. We were told by staff that training had improved and any additional training they felt would be beneficial to them was also obtained. This ensured they were competent to meet the needs of the people in the home. DS0000015860.V350511.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management and administration safeguards people, good health and safety policies and procedures were in place ensuring the safety of people in the home. EVIDENCE: A new manager was appointed in May 2007 she has applied to the Commission for Social Care Inspection to be registered and is awaiting her interview. The home has also appointed a deputy for each unit, which has much improved the management of the home and provided a well managed home for the people who lived at Flower Park. DS0000015860.V350511.R01.S.doc Version 5.2 Page 19 Quality monitoring systems were in place ensuring the home is run in the best interests of the people who live there. People said “we have completed questionnaires giving our views and thing have changed following the requests we have made”. The home managed some people’s finances and personal money, we checked some records, and these were well recorded and signed for by two people with all receipts kept, ensuring peoples financial interests were safeguarded. The home had a comprehensive health and safety policy. We were able to evidence that regular maintenance of equipment and systems was carried out. Risk assessments were carried out on all safe-working practices, regular audits were carried out on the building and all accidents were properly recorded and reported ensuring people in the home were safeguarded. DS0000015860.V350511.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 DS0000015860.V350511.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 OP27 Good Practice Recommendations It is recommended that the manager reassess the needs of people living on the to determine when additional staff may be required. It is recommended that when the new floor covering is obtained it is a type that is able to be thoroughly cleaned. This would alleviate the problem of the slight odour. It is recommended that the training files are re-organised for easy reference to determine when updated training is required. 2 OP26 3 OP30 DS0000015860.V350511.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 DS0000015860.V350511.R01.S.doc Version 5.2 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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