Inspection on 07/04/05 for Home Park Nursing Home

This inspection was carried out on 7th April 2005.

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

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

Other inspections for this house

Home Park Nursing Home 21/11/07

Home Park Nursing Home 17/10/06

Home Park Nursing Home 28/10/05

Home Park Nursing Home 21/10/04

Home Park Nursing Home 17/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Home Park Nursing Home Knowle Lane Horton Heath Southampton SO50 7DZ Lead Inspector Marilyn Lewis Unannounced 07/04/05 09:30 a.m. 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. Home Park Nursing Home Version 1.10 Page 3 SERVICE INFORMATION Name of service Home Park Nursing Home Address Knowle Lane, Horton Heath, Southampton SO50 7DZ 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) 02380 692058 02380 613901 Kendalcourt Ltd Anthony Jozef Pekarik CRH 35 Category(ies) of DE DE(E) registration, with number of places Home Park Nursing Home Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of persons for whom accommodation and nursing care is provided at any one time shall not exceed 35. 2. All service users must be at least 50 years of age. Date of last inspection 21/10/04 Brief Description of the Service: Home Park is a care home providing nursing care for thirty-five residents who have dementia. The home is privately owned and is situated in a quiet rural location in the village of Horton Heath. Residents are accommodated in twentythree single rooms and six shared rooms and there are three communal lounges and a dining room. Five of the single bedrooms have en-suite facilities and there are three bathrooms with assisted baths and three separate toilets. Accomodation is provided on two floors with a passenger lift allowing access to each level. A variety of aids and adaptations provided around the home enable residents to move more independently. Home Park Nursing Home Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 6 hours on the 7th April 2005. the inspector toured the premises and four staff records and three care records were inspected. Four of the ten staff on duty, three residents, six visitors and a GP were spoken to during the visit. What the service does well: What has improved since the last inspection? The home has an ongoing refurbishment programme and has purchased new dining furniture, chairs and bedroom linen and curtains since the last inspection. A sensory/quiet room is being built to provide a calm, restful area for residents. The registered manager had researched the benefits of such a room for the home. During the last inspection cleaning fluids had been stored in bathrooms and toilets, posing a possible risk to residents. This inspection found that all hazardous substances were being stored securely. Home Park Nursing Home Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Home Park Nursing Home Version 1.10 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 Home Park Nursing Home Version 1.10 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, 4, 5 A Service User Guide was not available, however prospective residents are provided with good information in the Statement of Purpose and through visits to the home, enabling them to make a choice about where they would like to live. EVIDENCE: The home provides information for prospective residents through a Statement of Purpose. However a Service User Guide was not available for residents. Residents are given a written contract on admission outlining the terms and conditions for living at the home. The document includes the fees that are payable and what is covered by those fees. A visiting GP commented on the good quality of care provided by the staff at the home and said that communication between the surgery and staff was very good. The GP said that all instructions and advice she had given the home with regard to the health care of residents had been followed and that staff contacted her if there were any concerns. Home Park Nursing Home Version 1.10 Page 9 Prospective residents and their relatives are able to visit the home prior to admission, which is on a trial basis. Relatives spoken to said that they had been welcomed in a friendly, caring manner when they visited the home. Home Park Nursing Home Version 1.10 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, 9 The procedures followed by staff for dealing with medication are sound, however the lack of clear guidance in the form of up to date care plans for each resident has the potential to place residents at risk. EVIDENCE: Individual care plans were not available for one resident admitted to the home three weeks prior to the inspection. Care plans seen for three residents were incomplete. Records indicated that two residents could be verbally aggressive but there were no plans for behavioural issues. The records also lacked plans for personal care needs and daily records documenting that the resident had been washed or bathed contained many gaps. The records seen did not indicate that the residents had been involved in any social activities and there were no activities taking place during the time of the visit This was an outstanding requirement form the inspection dated 21/10/04. Medication records seen were up to date and medication was stored appropriately. Trained nurses administer the medicines. At the time of the inspection there were no residents who required controlled medicines or who self-administered medication, but procedures for staff to follow were in place Home Park Nursing Home Version 1.10 Page 11 should this situation change. was available for staff. Information on the medicines used at the home Home Park Nursing Home Version 1.10 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 15 The home provides the residents with interesting and varied meals served in a friendly, welcoming atmosphere. EVIDENCE: Six visitors spoken to during the inspection visit commented on the welcome they received from staff. The visitors said that they could come at any time and see the residents either in the communal lounges or in their own room. A record is kept of all visitors to the home. Menus seen indicated that residents were provided with a varied and interesting diet. The main meal at lunch was sweet and sour chicken with carrots, broccoli and mashed potato, followed by apple sponge and custard. The inspector spent time with the residents at lunch and all residents spoken to, commented on their enjoyment of the meal. Staff said that an alternative choice of meal was provided if a resident did not wish the meal offered but that the cook knew the likes and dislikes of the residents and planned the meals accordingly. Drinks were available for residents throughout the day. Staff were seen to assist residents in a friendly, unhurried manner. Home Park Nursing Home Version 1.10 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Procedures are in place to record and investigate complaints and visitors spoken to were aware of the process. EVIDENCE: The registered manager said that no complaints had been received by the home in the last year. Procedures are in place to document a complaint should the need arise. The complaints procedure required updating to change the name of the Commission and this was done during the inspection visit. Home Park Nursing Home Version 1.10 Page 14 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, 22, 23, 24, and 26 The home has an ongoing plan for refurbishment and redecoration, which provides the residents with a warm, comfortable, safe environment. EVIDENCE: Since the last inspection the home has purchased new dining room furniture, providing an improved seating area for residents. A sensory/quiet room is currently being developed in part of one of the lounges. It is anticipated that the work on the room will be completed very shortly and there are also plans to redecorate the corridors of the home, which require attention to the paintwork and to replace carpets in some of the bedrooms. The twenty-three single and six double residents’ rooms looked bright and cheerful with co-ordinating bed linen and curtains. Many of the windows give pleasant views over the gardens and surrounding countryside. A resident commented on the enjoyment she received from watching the birds feeding just outside the main lounge window. All areas of the home looked very clean. Home Park Nursing Home Version 1.10 Page 15 Home Park Nursing Home Version 1.10 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 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, 29 and 30 Although staff are provided at sufficient levels, the recruitment procedures are not robust and do not provide protection to the residents of the home. EVIDENCE: The home employs eight trained nurses and twenty-two carers, three of which are trained nurses from overseas. The home also employs separate catering, laundry and domestic staff and an administrator is due to take up her position next week. Residents and visitors spoken to commented on the friendliness and caring attitude of the staff and a GP visiting said that the staff were ‘very good’. Records seen for four staff members indicated that the home had not undertaken all the necessary recruitment checks to ensure protection of residents. One of the files did not contain any references and another file had only one reference. There was no evidence of Criminal Records Bureau checks for two staff members, however one of those did have a police check from their home country. The records of a trained nurse did not contain confirmation that the personal identification number for the Nurses and Midwifery Council had been checked. The registered manager of the home said that he would notify the Commission of the confirmation of the identification number and that staff without Criminal Records Bureau checks would work supervised until the checks were obtained. This was an outstanding requirement from the inspection dated 21/10/04. Home Park Nursing Home Version 1.10 Page 17 New staff members follow an induction programme that includes food safety and infection control. All the nursing and care staff had completed training in moving and handling and a number had attended training in dementia care, continence care, first aid and food hygiene. A training course for abuse awareness had been organised for May 2005. Home Park Nursing Home Version 1.10 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 35, 36, 37 and 38 Staff morale is high, however lack of fire training and formal supervision for some and the failure to complete the required quality assurance reports by the registered provider may pose a risk to residents. EVIDENCE: The registered manager is a qualified nurse with many years experience in providing dementia care. He has yet to complete the Registered Managers Award. Staff and visitors commented on the support they received from the registered manager. The home keeps small amounts of residents’ monies individually in a secure place. Receipts are kept for all transactions and records seen for three residents matched the monies held. Home Park Nursing Home Version 1.10 Page 19 Staff members spoken to were very commented on their enjoyment of working at the home and the support and encouragement they received from the registered manager and the deputy manager. However, only a few members of staff received formal supervision allowing them the opportunity to regularly discuss all aspects of practice and career development needs on a one to one basis. The registered provider had not forwarded the required Regulation 26 notices to the Commission for a considerable length of time and there was therefore no evidence of quality control by the registered provider. Fire records indicated that nine staff members had not received fire safety training and four had not attended a fire drill in the last year. Home Park Nursing Home Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 3 x 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 x 3 3 3 x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 x x x 3 2 2 2 Home Park Nursing Home Version 1.10 Page 21 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard OP1.2 OP7 Regulation 5 15(1) Requirement The registered person must provide a service user guide for all residents. The registered person must after consultation with the resident or their representative, prepare a written care plan identifying the residents need in respect of health and welfare and how those needs are to be met. This is an outstanding requirement of the inspection dated 21/10/04 The registered person must ensure that staff records include all the information required in Schedule 2 of the Care Homes Regulations, including written references. This is an outstanding requirement of the inspections dated 17/06/04 and 21/10/04. The registered person must ensure Criminal Record Bureau checks are completed for all staff prior to their commencement of employment at the home. The registered person must ensure that all staff receive formal supervision at least six times a year. The registered provider must Version 1.10 Timescale for action 30/06/05 3. OP29 19(1) 31/05/05 4. OP29 19( 30/04/05 5. OP36 18(2) 30/06/05 6. OP37 26 30/04/05 Page 22 Home Park Nursing Home 7. OP38.2 23(4)(d) (e) provide the Commission with monthly written reports. The registered person must ensure that all staff receive training in fire safety and attend fire drills. 31/05/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Home Park Nursing Home Version 1.10 Page 23 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton SO14 1GW 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 Home Park Nursing Home Version 1.10 Page 24 - 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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