Inspection on 09/10/06 for Abington Park View

This inspection was carried out on 9th October 2006.

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

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 10/10/05

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 Irene Miller Unannounced Inspection 9th October 2006 11:30 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.V314023.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. Green Park Care Home DS0000056079.V314023.R01.S.doc Version 5.2 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 info@msaada.co.uk 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.V314023.R01.S.doc Version 5.2 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. 10th October 2005 3. 4. 5. 6. Date of last inspection Brief Description of the Service: Green Park registered in January 2005 is a care home that provides nursing care, generally to people over the age of 65 years. In addition he home can care for up to 10 people who have a physical disability, and there is the provision for one person under the age of 65 to live at the home. 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 that 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. Fees are approximately £427.78 per week based upon the dependency level. Green Park Care Home DS0000056079.V314023.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This inspection was a ‘Key Inspection that focused on the key standards under the National Minimum Standards and the Care Standards Act 2000 for homes providing care for older people. The primary method of inspection used on this unannounced inspection was ‘case tracking’ that involved selecting two residents and tracking the care they receive through review of their care plans, records, discussion with the residents, staff on duty, visitors and general observation of care practices and the environment. Prior to the inspection the Commission for Social Care Inspection sent out to the home a pre-inspection questionnaire for completion by the manager and comment cards for distribution to residents, visitors/relatives, and healthcare professionals that visit the home. The acting manager Trudy Frost was available throughout the inspection visit. The pre-inspection questionnaires was returned to the Commission for Social Care Inspection and provided information on the management systems within the home. The inspector spent two and a half hours planning the areas to focus on at this inspection, based upon information gained from reviewing the homes service history, the last two inspection reports and information from the pre inspection data collection. The inspection took place over a period of approximately six hours. What the service does well: Much work has taken place to meet the requirements that were made following the last inspection visit to the home. There has been a commitment to provide all staff with basic induction training, and training for the registered nurses employed at the home to retain their clinical nursing skills and knowledge through updates to training. Green Park Care Home DS0000056079.V314023.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Door wedges were seen to be habitually used throughout the home, it was observed that for residents who spend long periods within their bedrooms there was a need for the doors to be open, to reduce the risk of become isolated and to ensure that staff could closely monitor the residents safety. However within the residents care plans and within the fire risk assessment there was no record of a risk assessment being carried in this area. The registered provider should consult with the fire safety authority to address this safety area. The nurse call system was extremely loud and intrusive, the inspector spent some time with residents in the lounge and observed one resident becoming increasingly disturbed by the loud sound that was produced each time that the nurse call system was activated. The registered provider is strongly urged to consider upgrading the system to a more appropriate nurse call system, that would not encroach or impact directly on the resident’s living space. The Registered Provider must conduct monthly-unannounced Regulation 26 visits to the home and provide a written report of the visit to the registered manager and the Commission for Social Care Inspection. Please contact the provider for advice of actions taken in response to this Green Park Care Home DS0000056079.V314023.R01.S.doc Version 5.2 Page 7 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.V314023.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Green Park Care Home DS0000056079.V314023.R01.S.doc Version 5.2 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 the following standard(s): Standard 3 (standard 6 is not applicable to this service) Quality in this outcome area is good. The admission process enables prospective residents to make a fully informed choice as to whether the home can meet their needs and expectations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes statement of purpose and service user guide is made available to all prospective and existing residents. Through discussion with residents it was confirmed that they were satisfied with the homes admission procedures and that they felt that the home were meeting their needs. One resident said that they had been at the home on respite care and due to personal changes in their life they had chosen to stay as a permanent resident and was happy with the care that they received at the home. Green Park Care Home DS0000056079.V314023.R01.S.doc Version 5.2 Page 10 The care plans viewed had pre admission assessments that had been carried out by the home prior to the residents moving and in there was also copies of assessments of needs that had been carried out by the placing authorities. Green Park Care Home DS0000056079.V314023.R01.S.doc Version 5.2 Page 11 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): 7,8,9 & 10 Quality in this outcome area is good. Residents can be assured that the home can meet their health and personal care needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The individual care plans identified where residents required health and personal support and contained instructions for staff to follow on how these needs were to be met. There was risk assessments in place where residents had been identified as being at any significant risk, such as for the prevention of falls, pressure care, nutrition, moving and handling and the assessments had been regularly reviewed. Within the care plans the input from healthcare professionals such as the district nurse and general practitioner was recorded, and the treatment and action taken to address any health care needs was recorded and reviewed. Green Park Care Home DS0000056079.V314023.R01.S.doc Version 5.2 Page 12 Individual health care needs of the residents, were identified and there was detailed information on the treatment and prevention of pressure sores, nutritional assessments, fluid intake monitoring and wound management. The daily records indicated that staff observe and monitor the resident’s needs and that action is taken to address changing needs One of the residents case tracked required a high input of clinical nursing skills and detailed information was available within the care plan. Information was available on health care monitoring, such as pressure ulcer prevention and management, and artificial (PEG) feed systems (Percutanious Endoscopic Gastronomy Feeds). The nursing staff employed at the home hold the responsibility for the administration of resident’s medication. The medication storage and administration records were seen to be in good order, medication was stored securely and all records seen demonstrated that the medication systems were well managed, a visit had taken place recently from the dispensing pharmacy and no areas of concern had been raised following the visit. Records were available to demonstrate that medication no longer in use was disposed of through a licensed waste disposal company. Staff were observed treating residents in a respectful and courteous manner. Residents were addressed by their preferred name; residents said that they were very happy with the care they received at the home. Within the care plans the resident’s wishes regarding resuscitation had been recorded, and a resuscitation policy was in place. Green Park Care Home DS0000056079.V314023.R01.S.doc Version 5.2 Page 13 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): 12,13,14 & 15 Quality in this outcome area is good. The home endeavours to meet the resident’s social, cultural, recreational and occupational expectations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was an activity programme on display within the lounge and on the day of inspection the planned morning activity was to be a quiz, it was noted that no quiz was taking place. One resident when asked about the provision of activities said that the activities advertised on the board don’t always take place, however they did say that staff try to spend time with them and that they did enjoy taking part in the music and movement session that takes place every 2 weeks. One resident was observed completing a jigsaw puzzle and the staff were observed to spend time with the residents, when speaking with the staff they were aware of each residents likes and dislikes in terms of how they choose to spend their time. Green Park Care Home DS0000056079.V314023.R01.S.doc Version 5.2 Page 14 Opportunities for residents to worship according to their faith were made available, representatives from the local church visits the home to provide one to one pastoral support. The menus seen contained a variety of homely meals and for residents that required vegetarian, or special diets to meet their healthcare or cultural needs this was accommodated by the home. There was a vacancy for a full time cook and the acting manager anticipated that a cook would soon to be appointed. The homes management had sought the advise of a company specialising in nutrition for the elderly and those on artificial feeding systems, PEG (Percutanious Endoscopic Gastronomy) feeding systems. The main kitchen was seen to be clean and tidy, there was cleaning schedules and food safety monitoring systems in place to prevent the cross contamination of foods. The member of staff working within the kitchen had a sound knowledge of the dietary needs and preferences of the residents living at the home. Green Park Care Home DS0000056079.V314023.R01.S.doc Version 5.2 Page 15 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): 16 & 18 Quality in this outcome area is good. Residents can be assured that any complaints or concerns that they may have will be listened to and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure is made available to all new residents and their representatives, and there is a copy of the procedure on display within the entrance lobby of the home The home keeps a record of all complaints made, and a record of the actions taken by the homes management to address and resolve them. Since the last inspection visit one complaint had been raised at the home and The Commission for Social Care Inspection (CSCI) was satisfied that the home had addressed the complaint in accordance with the homes complaints procedure. The home has a policy on the protection of vulnerable adults and in house training is provided for all staff on recognising what is abuse and how to report any suspected or actual abuse. Green Park Care Home DS0000056079.V314023.R01.S.doc Version 5.2 Page 16 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, 22 & 26 Quality in this outcome area is good. Resident live in a home that is clean, comfortable and well maintained, however the residents safety could be placed at risk through the habitual use of door wedges throughout the home, and the residents well being diminished by the intrusive nurse call system in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was a selection of equipment provided by the home to ensure that the residents physical and mobility needs could be met, such as pressure relieving equipment, wheelchairs, assisted showers and baths, grab rails, hoists and specialist feeding equipment. Green Park Care Home DS0000056079.V314023.R01.S.doc Version 5.2 Page 17 A limited tour of the building was conducted and bedrooms seen were personalised, with items of furniture and possessions such as photos, plants and ornaments. It was noted that door wedges were seen to be habitually used throughout the home, it was explained by the acting manager that for residents who spend long periods within their bedrooms there was a need for the doors to be open, to reduce the risk of become isolated and to ensure that staff could closely monitor the residents safety. However within the residents care plans and within the fire risk assessment there was no record of a risk assessment being carried in this area. The registered provider should consult with the fire safety authority to address this safety area. The nurse call system was extremely loud and intrusive, the inspector spent approximately twenty minutes within the residents lounge and observed one resident becoming increasingly disturbed by the loud sound that was produced each time that the nurse call system was activated. The registered provider is strongly urged to consider upgrading the system to a more appropriate nurse call system, that would not encroach or impact directly on the resident’s living space or well being state. The home was clean free from unpleasant odours, and systems were in place for the prevention of cross infection. Systems were in place for the disposal of clinical waste, sharps, and medication returns, and records were retained by the home. The external of the building appeared well maintained, a large timber decked patio area wrapped around the rear and the side of the building and there was outdoor seating available. The garden at the front of the building had a large lawned area with flowerbeds, it was noted that the bedding plants had finished their flowering season and were in need of uplifting. A new wrought iron garden gate had been fitted, and a keypad lock was on order to be fitted to the front door of the home to provide added security. Green Park Care Home DS0000056079.V314023.R01.S.doc Version 5.2 Page 18 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): 27,28,29 & 30 Quality in this outcome area is good. The staff team are skilled within their respective roles ensuring that the needs of the residents can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staffing levels on the day of inspection were sufficient to meet the needs of the current residents. Through discussion with the staff and training records available, it was demonstrated that staff were appropriately trained to carry out their tasks, and induction training was provided that covering mandatory requirements such as basic personal care, adult protection, fire awareness, heath and safety, moving and handling, food hygiene. Opportunities were available for staff to achieve a National Vocational Qualification in care levels 2 and 3. For registered nurses employed at the home training was provided to ensure that clinical nursing skills were continually updated in areas such as wound management and treatment, and artificial (PEG) feed systems (Percutanious Endoscopic Gastronomy Feeds), and the administration of medication. Green Park Care Home DS0000056079.V314023.R01.S.doc Version 5.2 Page 19 The staff files looked at evidenced that robust staff recruitment procedures were followed. Staff said that there were good communication systems in place with a half hour handover period, from shift to shift. The daily communications book was viewed and demonstrated that during each shift individual members of staff are allocated to carry out certain tasks and care for specific residents to ensure that the resident’s health, personal and social needs were met. Green Park Care Home DS0000056079.V314023.R01.S.doc Version 5.2 Page 20 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 & 38 Quality in this outcome area is good. The health and welfare of residents and staff are promoted and protected, however to ensure that the registered provider has done everything that is reasonably practicable to ensure the safety of residents and staff there is further work required. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager’s post has been vacant for some time, the registered provider has endeavoured to recruit a manager for the home, however to date a suitable candidate has yet to be found. The acting manager was observed during the inspection visit to have a good rapport with residents, visitors and staff. Green Park Care Home DS0000056079.V314023.R01.S.doc Version 5.2 Page 21 The registered provider and the acting manager had addressed many of the requirements made following the last inspection visit, and the acting manager demonstrated that there is a commitment to improve on the quality of care provided at the home. Quality assurance systems were in place to seek the views of residents and their representatives through the use of feedback questionnaires. However the registered provider is not in day to day contact with the home and therefore must conduct monthly-unannounced visits to the home under Regulation 26 of the Care Homes Regulations, Care Standards Act 2000, there was no written records available to demonstrate that the registered provider did carry out unannounced regulation 26 visits. Door wedges were in use throughout the home, and there was no evidence to demonstrate that the use of the door wedges had been risk assessed, the registered provider should address this area through consultation with the fire safety authority. The nurse call system was extremely loud, the registered provider should consider upgrading the system to a more appropriate nurse call system, that would not encroach or impact directly on the resident’s living space. Green Park Care Home DS0000056079.V314023.R01.S.doc Version 5.2 Page 22 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 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 2 X X 2 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 2 Green Park Care Home DS0000056079.V314023.R01.S.doc Version 5.2 Page 23 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 OP19 Regulation 13 (4) (c) Requirement The use of door wedges must be risk assessed through consultation with the fire safety authority. Timescale for action 20/11/06 2 OP33 26 The Registered Provider must 20/11/06 conduct monthly-unannounced Regulation 26 visits to the home and provide a written report of the visit to the registered manager and the Commission for Social Care Inspection. 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 OP22 Good Practice Recommendations The registered provider should consider upgrading the nurse call system to a more appropriate system, that would not encroach or impact directly on the resident’s living space. Green Park Care Home DS0000056079.V314023.R01.S.doc Version 5.2 Page 24 Green Park Care Home DS0000056079.V314023.R01.S.doc Version 5.2 Page 25 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.V314023.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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