Inspection on 10/10/05 for Abington Park View

This inspection was carried out on 10th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Abington Park View 27/10/09

Abington Park View 28/04/09

Abington Park View 30/12/08

Abington Park View 04/07/08

Abington Park View 09/10/06

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

CARE HOMES FOR OLDER PEOPLE Green Park Care Home Green Park Care Home 475 - 479 Wellingborough Road Northampton NN3 3HN Lead Inspector Mrs Sara Morrison Unannounced Inspection 10th October 2005 11:00 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 Green Park Care Home DS0000056079.V256776.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 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. Green Park Care Home DS0000056079.V256776.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Green Park Care Home Address Green Park Care Home 475 - 479 Wellingborough Road Northampton NN3 3HN 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) 01604 475333 01604 472892 francischanyau@aol.com Msaada Ltd Mrs Maureen Elaine Keet Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22), Physical disability (5), Physical disability of places over 65 years of age (10) Green Park Care Home DS0000056079.V256776.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No person falling within the category older persons (OP) can be admitted where there are 22 persons of category older persons (OP) already in the home No person falling within the category/combined categories physical disability (PD)/physical disability persons over the age of 65 (PD(E)) may be accommodated in the home where there are 10 persons of category/combined categories PD/PD(E) already in the home. The home may accommodate 5 service users who fall within the category physical disability (PD). No person under the age of 50 years of age and who falls within the physical disability (PD) category can be admitted in the home. Total number of service users in the home must not exceed 22. To be able to admit the person who is named in the variation application dated 11th August 2005 and who is under the age of 50 years. 20th July 2005 3. 4. 5. 6. Date of last inspection Brief Description of the Service: Green Park registered in January 2005 and is a care home that also provides nursing care, generally to older people however some people under the age of 65 years may be accommodated. All bedrooms have ensuite facilities and there is a passenger lift giving access to all areas. There are a variety of communal areas including lounges and a dining room; the first floor lounge has pleasant views over the local park which is opposite the home. The home is situated in a residential area and is on a main road approximately two miles form the town centre. There is good public transport and local facilities. Green Park Care Home DS0000056079.V256776.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over five and a half hours during the morning and afternoon, was carried out as part of the regular inspection visits required by law and was unannounced. Prior to the inspection time was taken to review the information gathered since the last inspection and plan this inspection visit. The inspection included a tour of the communal areas and several bedrooms, inspection of certain records, discussion with three of the staff and the acting manager, discussion with service users and observation of the routines of the home. The method of inspection was to track the lives of several service users. This was achieved by speaking to them about the service they receive, observing them with staff, talking to staff and reviewing the records. What the service does well: What has improved since the last inspection? What they could do better: Improvements must be made in identifying the needs of service users, planning how these are to be met and giving guidance to staff on what to do to meet them. This includes things that must only be done by a qualified nurse and things that carers can carry out. There must be basic training for staff and staff must know what to do if they suspect abuse. All staff must have a police check before working with service users. Green Park Care Home DS0000056079.V256776.R01.S.doc Version 5.0 Page 6 The owners have not organised a quality assurance system and it is of serious concern that the owners have ignored the requirement to visit the home on a monthly basis as set out in the regulations. 8 requirements have been made in this report and how the owners respond will be used to judge their willingness and ability to run the home in accordance with the law and national standards for care homes. 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. Green Park Care Home DS0000056079.V256776.R01.S.doc Version 5.0 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 Green Park Care Home DS0000056079.V256776.R01.S.doc Version 5.0 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 the following standard(s): No standards in this section were reviewed at this inspection. EVIDENCE: Green Park Care Home DS0000056079.V256776.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7&8 The care planning process does not demonstrate that the healthcare needs of service users are identified or that action is taken to meet the needs. EVIDENCE: An assessment process is carried out prior to service users being admitted. There is a form that explores all areas and highlights particular needs. These had been completed for service users. There is a ‘standex’ system for recording the care planning information that is completed by the qualified nurses. Information about required nursing interventions was limited and inconsistently completed. For example for one new service user who is diabetic the ‘diabetic chart’ had been completed on one day (6.10.05). On reading through the daily notes staff had recorded her blood sugar levels for other days in this record. There were no care plans for this lady. No evidence that the management of her diabetes had been thought through and planned with guidance for staff on who was responsible for what and when. There was no information about acceptable boundaries for her blood sugar and no instructions on what to do if acceptable levels were exceeded. Green Park Care Home DS0000056079.V256776.R01.S.doc Version 5.0 Page 10 For another service user who appeared very thin and had fragile skin there was no nutritounal assessment or assessment of her skin/pressure area care. There was evidence that the G.P had visited her but there were no care plans for this lady, which was strange as the daily notes on the 26.9 and 3.10 05 stated “ care as plan”. See requirements. It was evident that not all relevant information from the assessment had been transferred onto the ‘standex’. It was also clear that care staff were not familiar with the ‘standex’ and there was little or no information to guide them in the delivery of care. Staff complete a record detailing when they have assisted a service user to wash or dress but there is no plan that highlights these needs or gives guidance to staff on how to meet them. The continence nurse visited during the inspection and said she had been asked by staff to visit two service users. The nurse felt that staff are proactive in contacting her for advice and support and are willing to attend training however said she considered that care plans are not sufficiently comprehensive in detailing service users’ continence needs. The acting manager has developed a form to record individual preferences and needs and said she is about to implement this. Advice was given that there must be a comprehensive and thorough care planning system for all care needs that is used as a working tool to direct the care delivery by all staff, and additionally there must be specific care plans relating to the nursing interventions. See requirements. For one service user who cannot take anything by mouth there was no plan for her oral care. There was some information following a recent review about using a soft brush to clean her teeth but there was no clear guidance about this. It was noted that there was a build up of plague on her teeth. Furthermore the toenails of this service user were very long and broken. The manager said that the chiropodist had been booked to visit her. See requirements. Green Park Care Home DS0000056079.V256776.R01.S.doc Version 5.0 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 the following standard(s): 12 & 14 Service users are enabled to make choices and have control over their lives. EVIDENCE: Service users said that they found the staff to be very caring and helpful. They said that could go to bed and get up when they wish. One lady said that she gets what she asks for she said the food is good and her bed comfortable. The lady went on to explain an event the previous day whereby another service user had become upset when her visitors had left and staff had spent a lot of time reassuring and comforting her. Staff have taken steps to acquire a portable artificial feeding system for the lady who cannot take anything by mouth. They explained that due to her current feed which has to be set up in her bedroom she cannot leave her room. They hope the portable system will allow her more freedom and opportunities for socialisation. Green Park Care Home DS0000056079.V256776.R01.S.doc Version 5.0 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 the following standard(s): 18 The findings regarding the protection of vulnerable adults were inconsistent and lead to the conclusion that service users may be at risk. EVIDENCE: There has been some training for staff about what to do if abuse is suspected. Several staff spoken to were clear about what constitutes abuse and said they would report any concerns they had. One new member of staff said that when she started work the acting manager told her that service users are to be treated with respect and their rights and dignity preserved. It was evident that staff were not sure of the correct procedure and were using a common sense approach. A senior carer shared some concerns she had regarding comments made separately to her by two other carers and which it is agreed could be viewed as abusive. This person said she had passed the information onto one of the qualified staff. In discussion the manager was not aware of these issues. See requirements. Green Park Care Home DS0000056079.V256776.R01.S.doc Version 5.0 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 the following standard(s): 19 & 26 The cleanliness in the home has improved however the condition of the front garden was not good and gave a poor first impression of the home. EVIDENCE: There is now a member of staff assigned to domestic duties for 5 hours a day and the home appeared much cleaner and better looked after than at the last inspection. The flowerbeds in the front garden were very overgrown and a lot of plants had died. Part of the handle of the front gate, which was reported as missing at the last inspection, remained in the same state. As the owners have taken no action following the report of the last inspection a requirement has been made in this report. See requirements. Green Park Care Home DS0000056079.V256776.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 & 30 Staffing levels have improved however recruitment and training practices are poor and do not ensure staff are trained and competent to do their jobs or that service users are protected. EVIDENCE: The acting manager has increased the levels of care staff on duty and senior care posts have been created. There is now a full time chef and a domestic who works five hours per day. There is no designated laundry staff although staff said they understood there would be a person for this tasks when the home had reached 15 service users. There was a nurse and two care staff on duty during the afternoon. One of the carers said she had been in post for three weeks and she and the other carer had started work on the same day. She said that she had completed an application form had given references and been interviewed for the job. She said that she had not completed a police check. The staff files for the two carers on duty were viewed and there was no evidence that a police or POVAFirst check had been completed. A requirement was made and is re-stated in this report. The member of staff interviewed said that her previous experience was gained looking after her grandparents and doing shopping for some elderly people. She said when she started work she was extra to the staff on duty for two Green Park Care Home DS0000056079.V256776.R01.S.doc Version 5.0 Page 15 shifts, and spent time meeting the service users and learning from other staff what to do. She said that she wasn’t told about what to do in the event of a fire but had done fire training at school. She said she has been shown by other staff how to use the hoist and has been told not to do this alone. The senior carer said that she had recently been promoted to this position and said that she considered the induction and supervision of new staff would be part of her role. This member of staff said that there is training available but induction is limited. She said that she has spoken to a new member of staff about a number of things she has witnessed and the new person has said she wasn’t aware that she was doing things incorrectly. The nurse on duty during the afternoon requested advice on where to access training for care staff and said she wanted to develop a training programme. The acting manager said that the previous manager had devised an induction record however this was quite complicated. At the request of the acting manager a person had visited from the local college to discuss staff undertaking National Vocational Qualifications (NVQ’s). It is evident that there is no training programme in line with ‘Skills for Care’ training targets. See requirements. Green Park Care Home DS0000056079.V256776.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 Service users live in a home that is run by a competent person however there is a lack of management and undertaking of responsibilities by the owners and this may have a detrimental impact on the well-being and safety of service users. EVIDENCE: Since the last inspection the registered manager of one of the other homes run by the Msaada group has become the acting manager of this home and this arrangement commenced on the 18th September 2005. The Commission for Social Care Inspection has been informed by one of the registered providers that this is for an assessment period of three months with a view to the manager applying for registration. The acting manager appears sufficiently knowledgeable and competent to undertake this role and has already made significant changes to the running of Green Park Care Home DS0000056079.V256776.R01.S.doc Version 5.0 Page 17 the home. For example documentation has been developed in relation to care plans and menus, there has been an improvement to staffing levels and staff said that things have improved since she came into post. The acting manager was not aware of any quality assurance system being undertaken and has asked for a quality audit as the home is being accredited for the Northants County Council ‘Rose’ standards early next week. The acting manager said a self audit system is an element of these requirements. It is disappointing that although the owner informed the inspector in July this year that a person had been appointed to carry out quality assurance for the group this has not happened. See requirements. There is no formal system of monitoring by the registered provider as required by regulation 26 of the Care Homes Regulations 2001. This matter was subject to requirements made following the last two inspections of another home run by the group. It is concluded that this lack of formal visiting by the owners has led to the number of requirements that have been made in this report. It is expected that registered people will assess their own service against the standards and address any shortfalls rather than responding to inspection requirements and recommendations. Visits as required under regulation 26 must be carried out. See requirements. Green Park Care Home DS0000056079.V256776.R01.S.doc Version 5.0 Page 18 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 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 1 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 1 X 3 X X X Green Park Care Home DS0000056079.V256776.R01.S.doc Version 5.0 Page 19 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. 1 Standard OP7 Regulation 15 Requirement The service users’ plans must include all information as detailed in standard 7 of the National Minimum Standards. There must be records that demonstrate that the health needs of service users as detailed in standard 8 of the National Minimum Standards are highlighted, addressed and monitored. The policies and practices of the home must ensure that service users are protected from abuse. The condition of the front garden must be improved and front gate repaired. There must be documentary evidence that all staff have been employed in line with the Care Homes Regulations 2001 and the Establishments and Agencies (Miscellaneous Amendments) Regulations 2004. There must be written evidence that all staff employed since April 2005 have received basic induction training. There must be a system to DS0000056079.V256776.R01.S.doc Timescale for action 04/11/05 2 OP8 12 04/11/05 3 4 5 OP18 OP19 OP29 13.6 23 (2) (b) 17 (2) & 19 04/11/05 04/11/05 21/10/05 6 OP30 18 04/11/05 7 OP33 24 31/12/05 Page 20 Green Park Care Home Version 5.0 8 OP33 26 review the quality of care. The Registered Provider must visit the home and provide detailed visit reports in line with Care Homes Regulations 2001 21/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Green Park Care Home DS0000056079.V256776.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Green Park Care Home DS0000056079.V256776.R01.S.doc Version 5.0 Page 22 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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