Inspection on 15/03/06 for Parc Vro

This inspection was carried out on 15th March 2006.

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

Parc Vro 30/01/08

Parc Vro 18/10/06

Parc Vro 12/07/05

Parc Vro 25/11/04

Parc Vro 13/05/04

Similar services:

Manor Lodge

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

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

CARE HOMES FOR OLDER PEOPLE Parc Vro Mawgan-in-Meneage Helston Cornwall TR12 6AY Lead Inspector Ian Wright Announced Inspection 15th March 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Parc Vro DS0000009130.V276974.R01.S.doc Version 5.1 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. Parc Vro DS0000009130.V276974.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Parc Vro Address Mawgan-in-Meneage Helston Cornwall TR12 6AY 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) 01326 221275 01326 221275 Mrs Alison Stevenson Care Home 15 Category(ies) of Dementia - over 65 years of age (3), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (3), Old age, not falling within any other category (15) Parc Vro DS0000009130.V276974.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Service users to include up to 15 adults of old age (OP) Service users to include up to 3 adults over 65 with dementia (DE{E}) Service users to include up to 3 adults over 65 with a mental illness (MD{E}) Total number of service users not to exceed a maximum of 15 Date of last inspection 12th July 2005 Brief Description of the Service: Parc Vro is a care home for up to 15 fifteen older people some of who may have dementia or mental health difficulties. The home is situated in a rural location outside the village of Mawgan, near Helston. The registered provider is Mrs A. Stevenson. The home also provides day care for up to five people during week days. The home is wheelchair accessible, and has a lift to the first floor. The home has gardens which are accessible to service users. There is suitable parking for staff, service users and visitors. Parc Vro DS0000009130.V276974.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over eight and three quarter hours. The inspection focused on previous statutory requirements. Standards not inspected at the last inspection were also assessed. The inspector was able to speak to the majority of service users, and the staff members on duty. The inspector examined the medication system, care records, and inspected the building. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Parc Vro DS0000009130.V276974.R01.S.doc Version 5.1 Page 6 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 Parc Vro DS0000009130.V276974.R01.S.doc Version 5.1 Page 7 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): 2, 3 The registered provider has developed a suitable contact / statement of terms and conditions of residency, but this must be issued to service users. A suitable system of pre admission assessment is in place, but pre admission assessments must be completed for new service users. EVIDENCE: A suitable contact / statement of terms and conditions of residency was inspected but this information needs to be issued to all service users. Files for service users admitted since the last inspection were inspected. The registered provider said she had assessed service users before admission, but had not filed the assessment. She was however unable to find the assessments during the inspection. There was a copy of a social services assessment for three of the four service users admitted since the last inspection. Parc Vro DS0000009130.V276974.R01.S.doc Version 5.1 Page 8 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, 9, 11 There is a suitable care planning system, and most service users have a care plan. However care plans must be developed for service users recently admitted. The medication system must be improved. Although care of the dying appears appropriate the registered provider must notify the Commission in writing when a service user dies. EVIDENCE: The majority of service users have a care plan, however these have not been completed for at least one service user who has recently been admitted. There is evidence care plans are reviewed. The medication system was inspected. A number of errors were apparent: • There was some over stocking of medication for example lactulose. This medication should not be reordered until stock is used up. Four dossets were in the medication cabinet containing aspirin for one service user. These were dated May / June 2006. The same medication was also contained in the monitored dosage system. Some of this medication needs to be disposed of. • Some medication stored was unlabelled. For example lactulose (2 bottles) and Omeprazole (1 box x 28 tablets) Parc Vro DS0000009130.V276974.R01.S.doc Version 5.1 Page 9 • • Two open bottles of Glyceryl Trinitrate tablets (which should be disposed of after 8 weeks) were in stock. These were prescribed on 8/11/06, and there was no date when they were opened. This medication was not recorded on the medication sheets. A dosage of medication for one service user appeared to be administered but was not signed for. All but one of the care staff has training regarding the administration of medication. External training needs to be arranged for the remaining staff member as soon as possible if the person is to continue to administer medication. The registered provider has a suitable policy regarding the care of service users who are dying. Care practices regarding those who are dying seem appropriate. However the registered provider has not notified the Commission for Social Care Inspection when several service users have died. It is essential this occurs in future. Parc Vro DS0000009130.V276974.R01.S.doc Version 5.1 Page 10 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, 15 Suitable activities and opportunities for religious observation are available. Service users are able to receive visitors when they wish. Information regarding advocacy services are available. Meals are provided to a high standard. EVIDENCE: The registered provider said day activity opportunities are available for service users. For example a musician visits the home and an exercise group is to start again shortly. A religious minister visits weekly. Activities are optional and service users can also spend time in their own bedrooms if they wish. Some service users are able to go out on their own. Parties are arranged for special occasions. The inspector spoke to several service users who all said they were happy with the activities provided. Routines are flexible and appear to be tailored around individual wishes. Service users have the opportunity to receive visitors when they wish. Information regarding advocacy services is available. The inspector shared a meal with service users, and this was to a good standard. The registered provider said a choice of meal is available and special diets are catered for. Staff provided service users with suitable support during the mealtime. Service users said they were happy with meals provided. Parc Vro DS0000009130.V276974.R01.S.doc Version 5.1 Page 11 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, 17 The home has a suitable complaints procedure. Service users legal rights are protected. EVIDENCE: A suitable complaints procedure was inspected. The registered provider or the Commission for Social Care Inspection has not received any complaints regarding the home. The registered provider said appropriate arrangements are in place to enable service users to vote. Suitable information is also provided regarding advocacy services. Parc Vro DS0000009130.V276974.R01.S.doc Version 5.1 Page 12 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, 21, 23, 24, 26 Parc Vro provides suitable facilities to meet the needs of service users. The home is well maintained, clean, comfortable and homely. EVIDENCE: The property was observed to be suitably maintained, safe, is comfortable and homely. Furnishings and decorations are to a good standard. The home has a lounge where service users can choose to relax. Other facilities include a dining room, and suitable bathrooms and toilets. Some of the bathroom / toilet locks need fixing, as it was not possible to lock the doors from the inside. The home was clean and hygienic on the day of inspection. The kitchen has recently been upgraded and some of the windows replaced. Bedrooms were observed to be appropriate to meet the needs of service users. All are decorated to suit individual tastes. Bedroom doors are lockable and service users can be provided with a key if this would not put them at risk and if they wish to have one. Size of bedrooms and communal areas is good. Parc Vro DS0000009130.V276974.R01.S.doc Version 5.1 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29, 30 Suitable staffing levels are provided to care for service users. Recruitment practices and staff training are not satisfactory and need improvement to meet legal requirements and the National Minimum Standards. EVIDENCE: Suitable staffing is provided. At least two staff are on duty between 0800 and 2200, although the staff rota indicates there are usually more staff on duty. One waking night staff and one sleep in staff are on duty between 2200 and 0800. A cook and a cleaner are employed. Information obtained when staff are recruited needs improvement. All staff must have information as outlined in Schedule 4 of the Care Homes Regulations 2002. For example two references, a copy of an application form, and at least one means of identity etc. must be obtained. A copy of a Criminal Bureau check / Protection of Vulnerable Adults check was not available for a new member of staff although the registered provider assured the inspector this had been completed. Mrs Stevenson said staff have a three-day induction. Staff do appear to be competent and knowledgeable. From the documentation inspected there is still gaps in training required by regulation. This includes training in first aid, manual handling, infection control, handling of medication, food handling and fire instruction. Staff also need suitable training regarding dementia and mental disorder. Parc Vro DS0000009130.V276974.R01.S.doc Version 5.1 Page 14 The registered provider has now been renotified for the fifth time regarding requirements for recruitment and staff training. The registered provider must provide: • An action plan regarding how any outstanding training will be delivered. Staff need to receive appropriate training by 1.7.06. Documentation regarding this must be provided. • A training policy outlining when staff, from the start of their employment, will receive appropriate training as required by regulation. • A staff recruitment policy, and suitable recruitment / staffing information for all staff. Failure of the registered provider to provide this could result in legal action being taken by the Commission for Social Care Inspection. Parc Vro DS0000009130.V276974.R01.S.doc Version 5.1 Page 15 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): 34, 35, 38 The registered provider has suitable financial procedures in place. Health and safety precautions are satisfactory although a suitable procedure for health and safety risk assessment needs to be developed. EVIDENCE: The registered provider said accounts are kept regarding the running of the home, and an accountant is employed to finalise accounts. Appropriate insurance has been arranged, and certificates for this are displayed. The registered provider said no service user moneys are kept or staff do not act as an appointee for any service user moneys or financial accounts. No valuables are kept on behalf of service users, although the registered provider said she would do so if required. Information regarding health and safety precautions was inspected. Satisfactory records regarding testing of portable electrical appliances, the Parc Vro DS0000009130.V276974.R01.S.doc Version 5.1 Page 16 electrical hardwire circuit, the central heating and the fire system were inspected. There is evidence the lift has been serviced. Health and safety risk assessments (outlining, where appropriate, control measures in place) need to be developed. This must include a risk assessment for the prevention of Legionella. Parc Vro DS0000009130.V276974.R01.S.doc Version 5.1 Page 17 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 2 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 1 10 X 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 X 3 X 2 X 3 3 X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X 3 3 X X 2 Parc Vro DS0000009130.V276974.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? YES 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 OP2 Regulation 5 Requirement Service users must be issued with a copy of a statement of terms and conditions of residency / contract (e.g. as part of the service user guide). This information must also be made available for inspection. The registered provider must complete pre admission assessments for all service users admitted. Evidence of this must be available on service user files. All service users must have a care plan after they are admitted to the home. The registered provider must ensure there is a satisfactory system for the receipt, storage, administration, recording and disposal of medication. All staff must receive suitable training by a qualified person. The registered provider must notify the Commission in writing when a service user dies. All bathroom and toilet facilities must be lockable. An over riding facility must be fitted if necessary. DS0000009130.V276974.R01.S.doc Timescale for action 01/06/06 2 OP3 14 01/06/06 3 4 OP7 OP9 15 13 01/06/06 01/06/06 5 6 OP11 OP21 37 16, 23 01/06/06 01/06/06 Parc Vro Version 5.1 Page 19 7 OP29 17 8 OP30 13, 18 9 OP38 13, 23 The registered provider must provide appropriate documentation for all staff employed from the date of this report, as outlined in Schedule 4.6 of the Care Homes Regulations 2002. (Timescale of 1/11/05 not met Fifth Notification) The registered provider must provide and be able to evidence appropriate training required by regulation as outlined in the report. Training regarding the handling of medication must also be provided. Copies of certificates (including NVQ training) must be maintained on individual staff files. (Timescale of 1/11/05 not met Fifth Notification) The registered provider must develop a suitable process of health and safety risk assessment. This must include, where appropriate, what control measures are in place. A risk assessment must be developed regarding measures taken regarding the prevention of Legionella 01/07/06 01/07/06 01/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Parc Vro DS0000009130.V276974.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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. 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