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Inspection on 30/06/08 for New Park House Nursing & Residential Home

Also see our care home review for New Park House Nursing & Residential Home for more information

This inspection was carried out on 30th June 2008.

CSCI found this care home to be providing an Poor service.

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.

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

What the care home does well

The home provides a physical environment that is appropriate to the specific needs of the people who live there. The well-maintained environment provides aids and equipment to meet individual needs. The bedrooms and communal rooms meet the National Minimum Standards (NMS) or are larger. All bedrooms in the new extension, and some in the main house, have en suite facilities. The lay out and design of the home allows for small clusters of people to live together in a non-institutional environment and there are larger communal rooms, which are spacious and grand. The grounds are attractive and provide a pleasant outdoor area, which is accessible to the people who live in the home including those using wheelchairs.

What has improved since the last inspection?

There has been an improvement in the number of laundry staff hours provided. Laundry staff are now employed at the weekends. Two nurses have been employed by the home as from April 2008 12 extra hours per day. As from August 2008 2 nurses are to be employed during the night hours to ensure continuity of care. There has been continual upgrading of the environment since the last Key inspection.

CARE HOMES FOR OLDER PEOPLE New Park House Nursing & Residential Home New Park, Chivelstone Grove Trentham Stoke-on-trent Staffordshire ST4 8HN Lead Inspector Yvonne Allen Unannounced Inspection 30th June 2008 09:30 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 New Park House Nursing & Residential Home DS0000026956.V369390.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. New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service New Park House Nursing & Residential Home Address New Park, Chivelstone Grove Trentham Stoke-on-trent Staffordshire ST4 8HN 01782 657664 01782 644555 info@newparkhouse.co.uk 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) New Park House Ltd Nora Patricia Sandra Wilson Care Home 92 Category(ies) of Dementia (29), Old age, not falling within any registration, with number other category (92), Physical disability (92) of places New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of care Care Home only (Code PC) To service users of the following gender; Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 92 Physical Disability (PD) 92 Dementia (DE) 29 The maximum number of service users to be accommodated is 92. 2. Date of last inspection 26th February 2007 Brief Description of the Service: New Park House is a registered care home currently providing nursing and personal care for up to 92 older people with varying levels of dependency. The home is a large detached property situated in its own spacious grounds in a residential area of Trentham, Stoke on Trent. The home has been extended over the years including a recent extension of a 29-bedded unit. The grounds are extensive and easily accessible and there is ample car parking facilities. Within the grounds of the home are 21 housing association supported bungalows for older people. An emergency care call system links each bungalow with the home and emergency support is provided by staff of the home. The home offers personal and nursing care for older people with varying physical limitations and needs. The home is also registered to care for people with dementia care needs, but is not registered to accept people with mental health needs requiring nursing care. The new extension – which was registered in January 2008 can accommodate up to 29 people. Currently some the people accommodated in this unit have personal care needs, some have dementia care needs and some people have come from the hospital whilst waiting to go home or to another placement. New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 5 The fees charged by the home range from £349.00 to £600.00 per week. Additional charges are incurred for hairdressing, toiletries, newspapers, magazines and transport. New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 star. This means that the people who use this service experience poor quality outcomes. The inspection process commenced several weeks prior to the visit and was not fully completed until 18/07/08. This was because we were still receiving information about the home from people using the service, their relatives, and purchasers of care. All of the Key minimum standards were assessed and for each outcome a judgement has been made, based on the evidence gathered. These judgements tell us what it is like for the people who live in this home. Prior to the inspection visit the Providers had completed a self-assessment tool, which is known as the Annual Quality Assurance Assessment (AQAA). Completion of the AQAA is a legal requirement and it enables the service to under-take a self-assessment, which focuses on how well outcomes are met for people using the service. It was completed to a good standard and gave detailed information about the services offered. The ways in which in we gathered evidence to make our judgements were as follows – We looked at any information we had received about the home since the last Key Inspection. This included any compliments, complaints and Safeguarding referrals we had received. We spoke with the people who live in the home We spoke with the staff who work at the home Discussions were held with the deputy manager of the home. The Registered Manager was on annual leave at the time of the inspection process. We spoke with professionals who are involved with purchasing care at the home. We examined relevant paperwork and documentation at the home. We walked around the home and we visited all the units. We looked at how staff interact with and care for the people who live at the home. At the end of the inspection visit we discussed our findings with the deputy manager and financial director. New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? What they could do better: From observation, evidence gained and the views of people and staff, it was identified that management of the home was not as effective as in previous inspections. This is having an overall effect on all the outcomes for the people who live at the home. Health and Safety of the people who live in the home is compromised and the home is not run entirely in the best interests of the people who live there. There are inconsistencies in the planning and delivery of personal and health care needs and the people who live at the home cannot always be assured that their individual needs will be met or that they are safe. There is a complaints procedure in place but people who use the service say that they do not always feel safe or listened to by staff, and that their concerns are not always taken seriously. New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 8 There is a lack of knowledge around restraint therefore it cannot always be guaranteed that people are safeguarded. The numbers of staff provided are not always adequate to meet the needs of the people who live there and people’s safety and welfare can be compromised. The arrangement for the home to accept people for “step down” care should be reassessed with a view to helping to improve outcomes for these people. Basic care needs are met, as agreed with the funding bodies, however, there is little or no help with rehabilitation and/or occupational therapy with a view to helping people to move on. 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. New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 9 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 New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 10 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): Standard 3 was assessed. Standard 6 was not applicable. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People moving into the home undergo an assessment of their needs prior to admission. EVIDENCE: Through examination of individual care plans and discussions with the deputy manager it was identified that admissions are not made to the home until a full needs assessment has been undertaken. For people who are self-funding and without a care management assessment, a skilled and experienced member of staff always undertakes an assessment. The assessment is conducted professionally and sensitively and involves the New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 11 individual and their family or representative, where appropriate. Where the assessment has been undertaken through care management arrangements the home insists on receiving a summary of the assessment and a copy of the care plan. Admissions to the home only take place if the manager is confident staff have the skills, ability and qualifications to meet the assessed needs of the prospective resident. We observed the family of a prospective resident being shown around the home. This was carried out in a professional and informative manner. New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 12 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): Standards 7,8,9 and 10 were assessed. Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. There are inconsistencies in the planning and delivery of personal and health care needs and the people who live at the home cannot always be assured that their individual needs will be met or that they are safe. EVIDENCE: We looked at individual care plan documentation and spoke with some of the people who live in the home, some visiting relatives, staff and the deputy manager. We also observed care practices and staff interaction. New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 13 Prior to and during the inspection process we received several concerns about the level of care provided at the home from relatives, staff members and visiting professionals. The standard of care planning is inconsistent and, whilst some plans were satisfactory, when we looked at others, it was evident that these are ineffective and that care is not always delivered as per plan. In some plans, the assessment of skin integrity was in place but then no care plan to identify what measures were being taken to avoid tissue damage. Whilst in another plan there was good evidence of tissue viability monitoring and inclusion of the Tissue Viability Nurse Specialist. Some care plans did not demonstrate that adequate measures are in place to safeguard people who are at risk of falls. Also, when we looked at records of accidents, this concluded that there had been a large number of falls in the home over the past few months. We have also received a complaint in reference to a person who had fallen and this had gone unnoticed by staff in the home. The person’s relative received a phone call from his sister from her bedroom informing her that she had fallen and was on the floor. When he arrived at the home 20 minutes later, she was still on the floor in her bedroom and he had to alert staff to the situation. Not all care plan documentation had been reviewed and evaluated as planned. We observed that, on occasions, call bells were left ringing for long periods of time. We have previously received a concern about this. We looked at 2 care plans in respect of people receiving “step down bed” care. These are people who have been nursed on a hospital ward and are awaiting placement elsewhere. There is very little in these plans, which indicate that these people are receiving any therapeutic or rehabilitation whilst they are in the home. A nurse commented, “We are not always sure what we are supposed to be doing with these people. One lady went home and I tried to contact the Social Worker to tell her that this lady would be unable to manage by herself at home – but she went home anyway.” The nurse also told us that people are very often unaware that they are leaving the hospital to come to a nursing home. She said that relatives ring up asking what is happening. A large number of the people who live in the home told us that they are not happy with the level of care afforded to them. Below are some of the comments we received – “I have to wait for the staff to take me to bed. Usually I am ready about 8pm but it can be anytime up until 10 or 11pm when they come. If I ring the buzzer New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 14 to ask to be helped to bed they sometimes ‘tut’ and are obviously annoyed with me.” “Sometimes I would like a lie in but they wake you up when they want to and I don’t have time to come round – they soon whisk you out of bed.” There is a sharp divide between staff – some staff are excellent and helpful but these are the minority.” “I don’t like it when I see visitors standing waiting for assistance and staff talking loudly in corridors and not helping – they can be very loud.” “I have to ask for my jug of water to be changed – sometimes its there for up to 3 days without being changed.” “Staff don’t want to take residents to the toilet until ‘toilet time’ one member of staff said to me when I came to visit – “you’re not going to take her to the toilet again are you?”” “I reported that she had a bad chest 3 weeks ago but as far as I am aware nothing has been done about it – they haven’t told me anyway.” “We often hear the call bell left ringing for long periods of time.” “Everything is fine but we need more staff.” “Too many young ones who don’t know what they’re doing.” “Not enough staff and young ones are too rough.” “My wife waited 45 minutes to be taken to the toilet the other day – I complained to the social worker and this complaint is being dealt with by the deputy manager.” “The staff dress all the residents nice, taking care with their appearance. She has really thrived this last month since has been in here.” The nurses were observed administering the lunchtime medication – taking the drugs trolleys to the dining rooms. Since the last Key inspection we have received a complaint about residents having to wait for long periods of time to receive their medication. We did not find this to be the case at the time of our visit. We have also received complaints from relatives of people who live in the home and visitors to the home about standards of care in the following areas – • Lack of attention to personal hygiene. • No fluids left in bedrooms. New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 15 • • Lack of dignity – staff speak to residents without a thought for their dignity. Poor and dangerous moving and handling techniques. New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Life in the home is made flexible and varied but individual autonomy cannot always be guaranteed. EVIDENCE: We spoke with one of the activities co-ordinators in the home. She told us about the programme of entertainment and activities in place. She also explained that regular trips out are arranged and we saw photographs of these and other events held at the home. We saw an activity session commencing in the main lounge. Staff and the people who live in the home told us that these activities and/or entertainment take place daily. New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 17 We were informed that spiritual needs are catered for and there are regular Church services held in the home. These were documented in the programme of activities. Links with the local community are maintained mainly with events run by the home such as coffee mornings and fetes. There were also records and photographs of people visiting local places of interest. Visiting is not restricted and visitors were observed coming and going throughout the day. Some residents are consulted or listened to regarding the choice of daily activity, but this process could be improved. The following comments were received from 2 people who were sitting in wheelchairs by the front entrance looking out at the sunny weather – “I wish I could go out – they say that they haven’t got time”. “There is nobody to take us for a walk out”. We received a concern from a visiting professional that people accommodated on the newly built unit were unable to watch their televisions due to technical faults resulting in very poor pictures. The person stated that this had been raised on more than one occasion with management but that nothing had been done about it. When we spoke to the Deputy Manager at the time of the visit she told us that this problem was being addressed and that the electrician was working on it. We spoke with the relative of a person staying on the new unit. She told us – “My Mother is very well looked after it’s a lovely unit here, she has her whisky – it was her birthday on Saturday and they made her a cake - just like home from home. The hairdresser comes on Wednesday – she had it coloured. She likes her make up and the staff help her to apply this.” We observed the serving of the lunchtime meal and spoke with the Head Cook. The food in the home is of satisfactory quality, well presented and meets the dietary and cultural needs of people who live there. Staff are trained to help those individuals who need help when eating and are sensitive in their approach. The Cook tries to be flexible and attempts to provide a service that is as individual as possible, using the staff and resources effectively. New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. There is a complaints procedure in place but people who use the service say that they do not always feel safe or listened to by staff, and that their concerns are not always taken seriously. There is a lack of knowledge around restraint and it cannot be guaranteed that people are safeguarded from abuse. EVIDENCE: The home has a complaints procedure that meets the National Minimum Standards and regulations. The procedure is up to date and is displayed on a notice board in the home but is partially covered and hidden by a large plant. Some individuals say they know how to make a complaint but others do not. Staff are aware of the complaints procedure but do not always realise the importance of listening to, and then acting on peoples’ concerns. New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 19 We have received a number of complaints since the last Key Inspection from relatives, staff and visiting professionals, some of which are about the same issues with a lack of action being taken to address them. Most of the staff have had training around safeguarding adults but others have a limited understanding in this important area. This leads to inconsistent knowledge and practice within the service. Complaints have been received from two different sources in respect of poor and unsafe moving and handling techniques used by staff in the home. There has been a large number of falls recorded which have been sustained by people living in the home. Examination of care plans identifies that these falls have not been monitored adequately and also points to a lack of staff supervision. In one instance it was recorded in the accident book – resident “threw herself out of her wheelchair when her request to go to the toilet was not immediately met”. This was the same individual whose family were asked not to take her to the toilet again by staff. Another individual – who had also sustained a number of falls, had a lap belt in place around her whist she was sitting in her wheelchair in her room. Although this may stop the person from falling it also means that she is unable to move freely. This can be regarded as restraint and should only be used following a multi disciplinary team meeting and agreement. Examination of her care plan could not identify that such a meeting had taken place or that the decision to use the lap strap was in her best interests. New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a pleasant homely environment, which has been adapted to meet individual needs. EVIDENCE: We walked around the home and looked at the communal areas, the kitchen, laundry and a selection of bedrooms. We spoke with the housekeeper, relatives and people who live in the home. The home provides a physical environment that is appropriate to the specific needs of the people who live there. The well-maintained environment provides New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 21 specialist aids and equipment to meet their needs. The home is a pleasant, place to live and the bedrooms and communal rooms meet the NMS or are larger. All the bedrooms on the new unit and some of the bedrooms in the existing home have en-suite facilities. The lay out and design of the home allows for small clusters of people to live together in a non-institutional environment. Bedrooms are only shared in limited situations and when this happens it is only by agreement with the people concerned. They are always given the choice to move into a single room when one becomes vacant. Screens are provided for privacy and the rooms reflect the chosen décor and personal belongings of both people Residents are encouraged to personalise their bedrooms. All the home’s fixtures and fittings meet the needs of individuals and can be changed if their needs change. The shared areas provide a choice of communal space with opportunities to meet relatives and friends in private. The bathrooms and toilets are fitted with appropriate aids and adaptations to meet the needs of the people who use the service, and are in sufficient numbers and of good quality. The home is well lit, clean and tidy and smells fresh. The management has a good infection control policy. They seek advice from external specialists, such as NHS infection control staff, and encourage their own staff to work to the home’s policy to reduce the risk of infection. New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 22 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): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staff are carefully selected to work at the home and have the skills required. However the numbers of staff provided are not always adequate to meet the needs of the people who live there and people’s safety and welfare is compromised. EVIDENCE: People say that there are times when they have to wait for staff support and attention. People report that the care they receive is rushed, inconsistent and impersonal. We observed this during our visit to the home. Staffing levels do not consistently meet the needs of the people using the service, and sometimes people’s health and welfare are being adversely affected. The home does not recognise the importance of individualised person centred support and sees personal care needs as the limit of support provided. New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 23 Staff are working extra shifts regularly and are tired, as a consequence staff moral is low. One of the nurses turned up for duty at 2pm on the day of the inspection visit, having worked a night shift the previous night. This meant that the nurse would have had no more than 6 hours sleep following a 12-hour night shift. This is very unsafe practice with the nurse not being fit for duty. This puts the people who live in the home and other staff at risk as well as the nurse herself. Supervision of people living in the home and supervision of staff care practices is lacking. As a result the safety of people living in the home cannot always be guaranteed and at times is compromised. The service has a recruitment procedure that meets statutory requirements. The procedure is followed in practice and there is accurate recording at all stages of the process. This means that the people using the service can be assured that appropriate personnel support them. The service recognises the importance of training, and tries to deliver a programme that meets statutory requirements and the needs of the people using the service. There are some gaps in the training programme and management tell us that they plan to deal with this. New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 24 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): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The management of the home is not effective, Health and Safety of the people who live in the home is compromised and the home is not run entirely in the best interests of the people who live there. EVIDENCE: We were not able to meet with the manager Sandra Wilson at the time of the inspection as she was away on annual leave and we were told that she had been off work for several weeks prior to her annual leave. New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 25 The Director Ann Hill was also on annual leave at the time of the visit. The Deputy Manager and the Financial Director were responsible for managing the home. There is a basic Quality Assurance system in place at the home but this needs further development. The service does not actively seek the views and suggestions of the people who live at the home in their monitoring of the services. Also, as a number of outcomes for people are in need of improvement, this indicates that the existing Quality Assurance system is not effective in producing results. The maintenance of personal allowances has remained unchanged since the last inspection. The administrator maintains this in an open and transparent system, which is accessible to residents at any time. In respect of Health and Safety, the manager has developed some systems that monitor practice and compliance with the plans, policies and procedures of the home. However we found that staff did not always follow policies and procedures. There is evidence of a high number of accidents and incidents at the home over the past few months including people falling. Staff have received basic training to enable them to work safely but tell us that they are under pressure and tired and observations by visitors identified that staff sometimes ignore basic safe practices and cut corners so that their jobs are easier. Also, people at risk of having falls are left unsupervised in their own rooms for long periods of time. This leaves people at risk of further falls and injuries. Call bells are not always attended to in a timely manner – we saw this during our visit and people told us about it. All sections of the AQAA were completed but the information does not give a true picture of the current situation within the service. The AQAA gave us some limited detail about the areas where they still need to improve. The ways that they are planning to achieve this is briefly explained. The data section of the AQAA was completed, although there are some inconsistencies. New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 26 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 2 8 2 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 1 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 3 x x 1 New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 27 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 12 (1) (a) and 15 (1) (2) Requirement The standard and efficiency of care plans and care planning documentation must be improved so that people can be assured that their assessed needs will be met. The use of lap belts must be reviewed and these not used unless this has been agreed as a result of a multidisciplinary team decision and in the best interests of the person. This is to ensure that lap belts not used as restraint. The provision of care staff must be reviewed and numbers improved in order to ensure that people are adequately supervised, have their needs met and are kept safe in the home. The provider must ensure that any concerns or complaints they receive are fully investigated and action taken where necessary. This is to ensure that people feel that their concerns are listened to and taken seriously. The provider will need to ensure that the monitoring systems in DS0000026956.V369390.R01.S.doc Timescale for action 01/09/08 2 OP38 13 (7) 01/09/08 3 OP27 18 (1) (a) (b) 01/09/08 4 OP16 22 (3) 01/09/08 5 OP33 24 (1) 01/09/08 New Park House Nursing & Residential Home Version 5.2 Page 28 6 OP38 10 (1) 7 OP7 14(1)(2) and 15 (1)(2) place are effective in improving outcomes for the people who live at the home. Overall management of the home must be made more effective in order to ensure that outcomes are improved for the people who live at this home In respect of people receiving care under the category of “Step Down” beds, clearer care plans must be produced so that people know what their goals are and staff in the home are able to assist in meeting these needs. 01/09/08 01/09/08 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. 2 3 Refer to Standard OP38 OP33 OP38 and OP33 OP12 and OP14 Good Practice Recommendations To audit moving and handling practices in order to ensure that all staff are adhering to the correct procedures. To audit and monitor the number of falls sustained by people in the home in order to help prevent injuries. To ensure that individual preferences and choices are upheld wherever possible in respect of daily life in the home. This is to help promote individual autonomy. New Park House Nursing & Residential Home DS0000026956.V369390.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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. 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