Inspection on 15/05/08 for Park Avenue Care Centre

This inspection was carried out on 15th May 2008.

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

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

Park Avenue Care Centre 18/06/07

Park Avenue Care Centre 29/06/06

Park Avenue Care Centre 03/02/06

Park Avenue Care Centre 14/07/05

Park Avenue Care Centre 24/01/05

Park Avenue Care Centre 19/10/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Park Avenue Care Centre Park Avenue Care Centre 69 Park Avenue Bromley Kent BR1 4EW Lead Inspector Maria Kinson Unannounced Inspection 15th May 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 Park Avenue Care Centre DS0000058005.V363280.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. Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park Avenue Care Centre Address Park Avenue Care Centre 69 Park Avenue Bromley Kent BR1 4EW 020 8466 5267 020 8466 5367 laura.smith@excelcareholdings.com 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) Park Avenue Healthcare Ltd Arlette Beebeejaun Care Home 51 Category(ies) of Dementia - over 65 years of age (33), Old age, registration, with number not falling within any other category (18) of places Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N 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 - Code OP (maximum number of places: 18) Dementia - over 65 years of age - Code DE(E) (maximum number of places: 33) The maximum number of service users who can be accommodated is: 51 18th June 2007 2. Date of last inspection Brief Description of the Service: Park Avenue Care Centre opened in April 2004 and is located in a residential area of Bromley. Accommodation and facilities are provided over four floors, with access by passenger lift. The basement houses various services, such as a training room, hairdressing salon, kitchen and laundry. The remaining three floors accommodate residents, all in single bedrooms with en-suite facilities. The ground floor has 15 beds and the first floor 18 beds; both of these units are for older people with dementia that require nursing care. The second floor has 18 beds for older people that require nursing care. The home has a small garden to the rear and off-street parking to the front and side of the property. The fees range from £750.00 to £850.00 per week (this information was supplied to the commission on 17/06/08). The fees do not include personal items such as hairdressing, newspapers and private chiropody treatment. Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection took place on 15/05/08 between 09:30am and 19:10pm and was undertaken by two inspectors. During the inspection all of the key standards were assessed and additional information was obtained about how the service protects the people that live in the home. The inspectors spoke with five relatives, six members of staff and four residents. Staff were observed communicating with residents and visitors and supporting people to eat and drink and take their medicines. All of the communal areas and two bedrooms were viewed on each unit. Comment cards were sent to six staff, six residents and five health care professionals to obtain their views about the service. Eleven comment cards were returned, five from residents, four from staff and two from health care professionals. Some of the feedback that we received is included in this report. The home was fully occupied at the time of this inspection. A thematic inspection was undertaken in the home on 19/09/07. This inspection looked at the quality of care that people with dementia experience when living in care homes. The report that was completed following this visit is available on request. What the service does well: Staff obtained information about people’s care needs and used this information to formulate a care plan. People received their medicines on time and good records were kept about medicines that were received and used in the home. Arrangements were made for people to see the GP or other health care professionals if necessary. Health care professionals said that staff were always “very helpful”. People said that their relatives and friends could visit at anytime. Relatives were satisfied with the care that their family member received in the home and said staff telephoned them if their relative was unwell or had to go to hospital. Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 6 Mealtimes were well organised and people were given adequate time and support to eat. People said they could choose what they wanted to eat from the menu. All of the communal areas and bedrooms were clean and pleasantly decorated. Various checks were carried out for new staff. This helps to ensure that people receive safe and suitable care. The home obtained feedback from residents and relatives and carried out regular audits to check that staff were following company procedures. Equipment was serviced regularly and fire safety arrangements were good. What has improved since the last inspection? What they could do better: Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 7 The Statement of Purpose provides useful information about the facilities and services that the home can offer but did not demonstrate how the home will meet the individual needs of people with dementia. Staff did not always follow some of the guidance provided in care plans and assessments. There was a varied programme of activities for people to take part in, but some residents said they would like to go out. Complaints were recorded and investigated but people were not told if the home had taken any action to address their concerns. This may make people feel that the home does not learn from its mistakes. The home had an adult protection procedure but senior staff did not always act in a timely manner to safeguard residents. Staff had some knowledge about the company’s whistleblowing procedure but seemed unaware that this procedure could be used to disclose issues other than abuse. The home provides a varied programme of training for staff but a significant number of the care staff had not received dementia training. As the majority of residents have dementia this topic should be mandatory and regular updates should be provided. No action had been taken to address a previous requirement about bedrail training for staff. 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. Park Avenue Care Centre DS0000058005.V363280.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 Park Avenue Care Centre DS0000058005.V363280.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 4. (Standard 6 does not apply to this home) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Written information about the home was made available to people that expressed an interest in the service and to people that were using the service. Staff carried out a care needs assessment before confirming if the home would be able to meet people’s needs. EVIDENCE: The registration certificate was displayed in the reception area. The Statement of Purpose was assessed during the thematic inspection in September 2007. The Statement of Purpose was found to include very little information about how the service meets the needs of people with dementia and how staff support this client group. The Statement of Purpose was reviewed and updated in February 2008 but there was no evidence that the Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 10 requirement that was made after the thematic inspection was addressed. See requirement 1. Staff had prepared two information booklets about the service, a ‘Statement of Purpose’ and a ‘Service User Guide’. These booklets were displayed in all of the rooms that we visited and there was evidence in resident’s files that these documents were supplied to people that expressed an interest in the service. Before people moved into the home a senior member of staff carried out an assessment to determine what support the person required. Staff recorded their findings on an assessment form and this document was then kept in the residents file for staff to refer to. The form prompted staff to consider the persons physical, social and emotional needs and to obtain information about medication and health issues. Written information was also provided by other professionals such as care managers and psychiatrists. We examined three pre- admission assessments, two for people that had recently moved into the home and one for a person that had lived in the home for several years. The assessments showed that staff obtained adequate information about the person, including details of past interests and hobbies. This level of detail is particularly helpful when staff are supporting people with communication difficulties or dementia. Following the assessment staff wrote to the resident or their representative to confirm if the home was able to meet their needs. During the last key inspection and the recent thematic inspection it was identified that staff would benefit from training, which would help them to understand the needs of people that have dementia. Although a significant number of the trained staff had attended dementia training very few of the care staff had access to this training. See requirement 2. Park Avenue Care Centre DS0000058005.V363280.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans included information about the action that staff must take to meet people’s individual needs and preferences. In a small number of cases the plan provided for individual residents was not followed. Medicines were well managed. This promotes resident’s comfort and wellbeing. EVIDENCE: We examined four sets of care records. Care plans included adequate information about peoples care needs and there were some references to individual preferences and routines. One care plan stated what the person could do for themselves and what support they required to wash and dress. The plan included information about the type of soap and cream that the person liked to use and said that staff should not wash the residents hair, as they preferred to let the hairdresser do this. Another plan stated that a resident might become aggressive if they were asked to take their medication. The plan stated that staff should take time to encourage and explain, and if the Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 12 person still refused they should try again later, when the person may be more receptive. We were able to see that staff followed the plan and that strategies to help the person to take their medicines were effective. Some of the records that we viewed were a little confusing in parts. For instance one care plan stated that a wound should be redressed on alternate days yet the wound evaluation chart indicated that staff were redressing the wound every four to six days. Another plan indicated that a resident should be checked every half an hour during the night yet the daily care records stated that staff were carrying out hourly checks. See requirement 3. Assessments were carried out to identify if people were at risk of falling, were likely to develop pressure sores or might become malnourished. If people were at risk a care plan was developed to state what action staff should take to maintain the persons health and safety. Care plans included information about maintaining people’s privacy and dignity and advised staff to encourage residents to choose what clothing they wanted to wear. One person had an infection, following a hospital admission. Clear guidelines were recorded in the persons care plan about the procedures that staff should follow to protect the other people that lived in the home. As soon as the swab results were received the previous restrictions were lifted and the care plan was reviewed. The resident concerned told us that staff kept her informed about what they were doing and were very supportive. Three, out of the four care plans that we viewed were agreed and signed by relatives. Information about wounds and pressure sores was seen on body maps, care plans, daily care records and wound evaluation charts. The records that we looked at provided clear information about the treatment that people were receiving and about how the wound was the progressing. A local GP visits the home regularly. Records were kept about any new treatment that was prescribed and advice that was given. We received written feedback about the service, from two health care professionals, that visit the service. They told us that the home was “caring and welcoming” and that staff showed an interest in their work. A number of residents that were at risk of developing pressure sores were using pressure- relieving air mattresses and cushions. One mattress was set at an inappropriate weight for the resident. This issue was discussed with a staff member and addressed immediately. Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 13 The management of medicines was good overall. Medicines were assessed on the ground and second floor units. Five medicine charts were examined in total. Staff recorded information on the medication chart about medicines received in the home and medicines that were left over from the previous months supply. A record was kept about all medicines that were given to residents and an explanation was provided when people refused or could not take their medicines. Information that was written by hand was checked and signed by two members of staff. Opening dates were recorded on eye drops. All medicines were in stock, this included medicines that were prescribed the previous day. Information was recorded about medicines that were sent for disposal. The home did not have any medicines that required special storage, but a cupboard was available for this purpose. Items such as jewellery and money that were seen in the controlled drugs cupboard during the previous inspection had been removed. The medication room and medication refrigerator temperature was monitored. The refrigerator and room temperature was a little above the recommended level at times. Staff were advised to monitor this issue. The home kept a small supply of homely remedy medicines such as paracetemol. Good records were kept about the receipt and use of these medicines. Staff addressed residents by their preferred name and made a point of bending down when they were speaking to people. Health care professionals that visited the home told us that staff always respected resident’s privacy and dignity. Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 14 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): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home arranged a varied and interesting programme of activities and entertainment for residents but this did not include activities outside the home. People were satisfied with the choice and quality of food provided and received support to eat. EVIDENCE: The home employed two activity co-ordinators. One of the activities coordinators had been absent from the home for a while and this was reflected in some of the comments that we received about the provision of activities. Staff prepared a weekly activity programme. The programme varied from week to week but usually included sessions that residents said that they enjoyed such as bingo, exercise, arts and crafts and games. Some of the art and craftwork that had been undertaken by residents was displayed in the training room. An entertainer visited the home once a month. Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 15 Several residents said that they enjoyed and benefited from a programme called SONAS that had recently been introduced. SONAS is a therapeutic activity that is particularly suitable for older people with intellectual difficulties such as dementia. The aim of the programme, either via group or individual sessions is to enrich the lives of the participants by activating each person’s potential for communication. We witnessed group sessions taking place on all of the units that we visited and noted that people were actively engaged and seemed to enjoy the sessions. Records were kept about activities that were provided by care staff on each of the units or facilitated by the activity co-ordinators. The records that we viewed indicated that there were regular activities taking place in the home and people were encouraged to take part. Some people chose not to take part in specific activities and spent all or part of the day in their room watching television or undertaking personal projects such as embroidery. Residents told us that there had been a reduction in activities in recent weeks but said there was always something happening each day. Residents said they were able to sit in the garden when the weather was good but there were no regular outings or trips. See recommendation 1. We spoke with five relatives. They told us that they could visit at anytime and were made to feel welcome. All of the people that we spoke with said their family member was well cared for and commented that staff were, “gentle and helpful”. One relative said that if he won the lottery tomorrow, he would still choose the same home for his mother. Some of the people that we spoke with said they were able to decide how and where they spent their time in the home and that staff respected their decisions. Staff encouraged people to make choices about what they wanted to eat and drink and where they wanted to sit in the lounge. We observed lunch on the first and second floor units. The dining room and tables were nicely laid out with flowers, menu and napkins. Staff followed the list of resident’s food choices and provided support to eat or to cut food up if necessary. The choice and variety of food was good and the menu looked well balanced. A number of alternative dishes were available and this included traditional West Indian dishes such as rice, salt fish and plantain. One person told us that they sometimes asked for bread and butter if they were not very hungry or didn’t want their meal. Most of the people that we spoke with said they liked the food that was provided in the home. Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 16 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): 16 and 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Complaints were recorded and investigated but there was little evidence that information that was obtained in this way was used to improve the service. The home had safeguarding procedures but senior staff did not always act in a timely manner to ensure that people using the service were protected. EVIDENCE: The complaints procedure was displayed and included adequate information about what people should do if they wanted to make a complaint. Information about the contact details for the Commission for Social Care inspection (CSCI) had been updated and there were timescales for staff to follow when investigating concerns. Guidance was provided about the different stages that people could follow if they were not satisfied with the response provided by the home. The home had received four complaints in the period since the last inspection. Complaints were logged in two separate records and were not always filed in a logical order. See recommendation 2. Although complaints were investigated the response did not always state what the home had done to address the persons concerns or to prevent a reoccurrence. An apology was given for poor communication in two instances but the letter did not state if Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 17 staff would receive any additional training or if their performance would be monitored. See requirement 4. We spoke to staff about the homes procedure for safeguarding residents. All of the staff that we spoke to had read the home’s procedure during induction training or when they were preparing their NVQ portfolio and were aware that they must report concerns or allegations to senior staff. One person was not familiar with the home’s on-call arrangements and was not certain who should be contacted outside of office hours. Staff were familiar with the term whistleblowing but did not recognise that this procedure could be used to report issues other than abuse such as poor practice or health and safety concerns. See recommendation 3. An incident was reported to the manager on the day of the inspection, by a relative. When we became aware of this incident, we advised the manager that she must refer the allegation to the Local Authority for investigation, under their safeguarding procedures. We were concerned that there was a delay in reporting this issue. See requirement 5. The allegation was investigated but could not be substantiated. Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 18 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): 19, 20, 21, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All of the areas used by residents looked homely and welcoming and were clean, tidy and comfortable. EVIDENCE: We looked at all of the communal areas and sampled two bedrooms on each floor. All areas were clean and tidy. Bedrooms were spacious and residents were able to bring some of their own furniture and belongings into the home if they wished. All of the bedrooms had a private en suite toilet and shower and additional toilets were located near the lounge and dining areas. There was one assisted bathroom on each floor. A maintenance person visited the home regularly to undertake minor repairs and to carry out health and safety checks. The radiator cover in room 7 was Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 19 loose. Staff said that this issue had been reported and would be addressed. A new refrigerator had been purchased for the middle floor unit. The communal areas were pleasantly decorated and comfortable. Residents were able to choose where they sat and some people chose to sit in the dining area or spent time in their bedroom. Work was planned to improve the appearance of the garden. The plans included providing some shade for people to sit under and areas that would stimulate people’s interest and senses, such as a water feature and sensory plants. In the period since the last inspection pictures of baths and toilets were placed on some of the doors to assist people to identify these rooms. Hand washing facilities were provided and clinical waste was stored in lidded bins. Linen was stored on shelving. Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 20 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): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was adequate staff to meet peoples needs and to maintain their safety and wellbeing. Staff had access to a varied and relevant programme of training. The people that lived in the home were protected by the company’s recruitment procedures. EVIDENCE: We looked at the duty roster for the period 12/05/08-18/05/08. The rota was easy to read and follow. The home had maintained or exceeded the staffing levels that were agreed with the commission during a meeting in 2006. Staff carried out their work in a calm and relaxed manner and responded promptly to requests for assistance. Staffing levels were clearly displayed on a notice board by the entrance to the unit, this is good practice as visitors could assess for themselves whether there is any shortfall in staffing provision at any given time. The home had reduced the number of adaptation nurses that worked in the home. This provides better continuity of care for residents. 97 of the care staff that worked in the home had a National Vocational Qualification in Care (NVQ) or an overseas nursing or social work qualification. Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 21 A number of overseas staff were undertaking part time work in the home whilst studying for a NVQ four qualification. The recruitment records for the three most recently appointed members of staff were examined. The files were well organised and contained all of the necessary documents with the one exception that one file was missing an up to date photograph of the member of staff. The manager agreed to address this issue. Since the last inspection some staff had attended food hygiene, medication awareness, health and safety, moving and handling, control of substances hazardous to health (COSHH), induction, safeguarding adults, wound care, MRSA, mental capacity act, activity, continence, challenging behaviour, first aid and fire safety training sessions. We received four comment cards from people that worked in the home. Staff were satisfied with the support and training that they received. The home has a dedicated training and resource room and staff said that the manager sent copies of relevant articles to the units for staff to read. The manager said that a computer would be purchased for staff use and staff would be encouraged to complete online training courses. Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 22 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): 31, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were systems in place to identify and address health and safety issues and to monitor and improve the quality of care provided in the home. EVIDENCE: The manager was registered with the commission following a process of assessment. The manager holds regular meetings with staff and had started to meet relatives on a ‘one to one’ basis. Staff said the manager visited their unit regularly to speak with staff and residents and was approachable and “helpful”. The atmosphere in the home was relaxed and staff were willing to provide feedback about the service. Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 23 We were told that the home does not hold any personal money or valuable items for residents. Relatives were invoiced directly for services such as hairdressing or newspapers, and some residents were able to look after their own money. The home has a comprehensive quality assurance system. A senior member of staff from the company visits the home at least once a month to assess the service and to speak with residents and staff. Staff completed regular care records, medication and health and safety issues audits. The home’s pharmacy supplier completes medication audits and provides written feedback about their findings. Satisfaction surveys were completed regularly and the results formed part of the home’s annual development plan. Team meetings were taking place but it was difficult to judge the extent of staff contributions or involvement from the minutes, as the notes were very brief. It would be useful to reflect the verbal response of staff members to individual items on the agenda. The records showed that staff had started to receive regular supervision. Two members of staff confirmed that supervision was now taking place and that records were kept about the issues and topics that they discussed. Accident and incident records were sampled. The records that we viewed provided adequate information about where and when the incident occurred and any treatment that was provided by staff. Notes were kept about any follow up that was required. A maintenance person visited the home regularly to carry out health and safety checks and to undertake routine repairs within the home and grounds. Health and safety records were sampled. All of the records seen were up to date and corresponded with the information that was provided by the manager in the pre- inspection (AQAA) report. Fire safety arrangements were good. Regular checks and service visits were undertaken to ensure that fire safety equipment was working properly. Staff received fire safety training and had an opportunity to practise fire safety procedures during fire drills. Domestic staff were conversant with COSHH procedures and dangerous chemicals such as cleaning fluids were locked away in a dedicated cupboard. There was no evidence on the training matrix or during discussions with staff that the previous requirement to provide bedrail training was met. This is a repeated requirement. See requirement 6. A bed rail assessment was completed before fitting rails and covers were provided for protection. Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 24 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 3 X 3 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 2 17 X 18 2 3 3 3 X X 3 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 N/A 3 X 3 Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 25 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 OP1 Regulation 4 Requirement Timescale for action 05/09/08 2. OP4 OP30 18 3. 4. OP7 OP16 15 22 The Statement of Purpose must be amended to give clear examples of the recognised needs of people who have dementia and what measures the home has put in place to ensure that these needs will be met. Repeated requirement. The previous timescale of 10/01/08 was not met. Specialist training for Dementia 05/09/08 Care and upholding Dignity and Privacy for people who have a cognitive impairment must be provided to all new staff and update training provided for staff at regular intervals. Repeated requirement. The previous timescale of 10/01/08 was not met. Staff must familiarise themselves 25/07/08 with and follow the information outlined in people’s care plans. People who raise concerns and 25/07/08 complaints about the service must be informed about the action that the home intends to take to address their concerns. DS0000058005.V363280.R01.S.doc Version 5.2 Park Avenue Care Centre Page 26 5. OP18 13 6. OP38 13 The Registered Person must ensure through training and supervision that staff are aware and fully understand the procedures to follow in the event of disclosure of abuse. Repeated requirement. The previous timescale of 10/01/08 and 30/07/07 were not met. The Registered Person must ensure that staff that are responsible for selecting, fitting, maintaining and checking bedrails receive appropriate training. Repeated requirement. The previous timescale of 10/01/08 and 23/07/07 were not met. 25/07/08 05/09/08 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 OP12 OP16 OP18 Good Practice Recommendations The activity programme should include regular opportunities for residents to go out in the community. Complaints records should be filed sequentially i.e. complaint, acknowledgement, investigation, response and outcome i.e. whether substantiated or not. Staff should receive further training about the company’s whistleblowing procedure. Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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. Extracts may not be used or reproduced without the express permission of CSCI Park Avenue Care Centre DS0000058005.V363280.R01.S.doc Version 5.2 Page 28 - 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. 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