Inspection on 15/05/07 for Park Farm House

This inspection was carried out on 15th May 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Park Farm House 26/10/07

Park Farm House 17/05/06

Park Farm House 12/12/05

Park Farm House 27/05/05

Park Farm House 10/02/05

Park Farm House 27/07/04

Park Farm House 01/12/03

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

CARE HOMES FOR OLDER PEOPLE Park Farm House Parkfield Pucklechurch South Glos BS16 9NS Lead Inspector Grace Agu Key Unannounced Inspection 15th May 2007 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 DS0000003369.V335701.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. DS0000003369.V335701.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park Farm House Address Parkfield Pucklechurch South Glos BS16 9NS 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) 0117 9372388 0117 9372388 jhanney04@aol.com Mrs. Margaret Joan Hanney Mr. Jeffrey Hanney Mrs Margaret Joan Hanney Mr. Jeffrey Hanney Care Home 7 Category(ies) of Dementia - over 65 years of age (7) registration, with number of places DS0000003369.V335701.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th May 2006 Brief Description of the Service: Park Farm House is an old farmhouse set in a peaceful location away from public amenities. It has been renovated and extended over the years. Access is from an unadopted lane to which the owners of the house have full rights of way at all times. The village of Pucklechurch is the nearest shopping area about a mile away. An infrequent bus service ends a little short of the lane to the home. The home is comfortably furnished and residents’ rooms are attractively decorated. Communal areas are spacious and well set out. The accessible garden is enclosed and residents are able to use this independently. Parking is available to the front of the home. Fees range from £430-£500 per week. DS0000003369.V335701.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced site visit as part of a key inspection that was undertaken over nine hours to review the requirements made at the last inspection and also to review the care practice to ensure that it is in line with the legislation and that best practice is followed at the home. The inspection visit also followed up a phone call from a concerned relative about the perceived insensitive approach used by the management of the home to inform the relatives that the home is having difficulty with meeting a person’s need due to a medical condition. Full report on this incident can be found in the body of the report under standard 7. At the last inspection seven requirements were made in regard to different areas of service provision to ensure that the residents are protected and that the quality of service provided is what they expect and deserve. It was disappointing to note that two of the requirements had not been met. As a part of this inspection two immediate requirements were issued in relation to following up accidents/falls and ensuring that the care plans and risk assessments are reviewed in order minimise occurrences. In addition another requirement was issued for lack of satisfactory recruitment documentation of a recently appointed staff member. A satisfactory response on how the home addressed the immediate requirements and action plan on how to prevent it from happening again was received before this report was completed. A tour of the building was undertaken and a number of records were viewed. Six residents, two staff members and one relative was spoken with on the day. What the service does well: What has improved since the last inspection? The home has adopted a new care planning system to enable it to provide personalised care to the residents. DS0000003369.V335701.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can DS0000003369.V335701.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. DS0000003369.V335701.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 DS0000003369.V335701.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): 1,2 3.4.5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Information is provided about the process of admission of prospective residents to enable the resident to make a choice of moving to the Home. However, it fails to provide assurance that their needs will be met Terms and Conditions of their stay is provided as a part of the process. EVIDENCE: The Homes’ Statement of Purpose and Service User Guide contained detailed information about services and facilities provided at the Home, including complaint procedure that contained information about the Commission for Social Care Inspection to enable the service user to contact the Commission if not satisfied with the outcome of their complaint. Terms and Conditions are provided to the prospective resident in relation to the fees to be paid and other conditions of their stay at the Home. DS0000003369.V335701.R01.S.doc Version 5.2 Page 10 Two care files, of recently admitted residents, contained pre-admission assessments. However there was no confirmation in writing that the home is able to meet their needs. DS0000003369.V335701.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): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ are looked after in respect of their health and personal care. However, individual care plans have not been clearly and comprehensively written to reflect the assessed needs of an identified resident. Medication policies and procedures are in place to protect residents’ health care and these are followed. EVIDENCE: Four care files were reviewed at this inspection All the care files contained detailed assessment of their needs however; the care plans had limited information in regards to how staff meet the needs of identified individuals. Furthermore it was noted that the home was managing a recently admitted resident with a challenging behaviour without appropriate comprehensive care plans and adequate instructions in regard to how staff are to manage this DS0000003369.V335701.R01.S.doc Version 5.2 Page 12 individual and no risk assessment in place to protect other residents and staff if the condition deteriorates It was noted that the individual had a care plan from the Adult Community Care Team however this was not being followed. Evidence from the daily progress notes showed that staff did not have the skills and competence to deal with the challenging needs of this person. For example entry on 30/04/07 states “resident quite aggressive tried to slap staff went to hit three residents, went to get ready, very abusive and hitting out at staff around bathroom and shouting at everyone.” There was a similar incident on 4/05/07 on both occasions there was no explanation about what action staff have taken regarding the above as there was no guidance to follow. An immediate requirement notice was issued for the home to put in place comprehensive care plans to meet this individual’s needs and ensure that risk assessments are in place to protect the individual and other residents This document was received at the Commission within the time scale given and will be the focus of the next inspection. Furthermore, the home must consult appropriate health professionals to assist the home to develop written guidance and to regularly support the home for the management of this individual. The inspector spent a considerable amount of time talking to the residents in the lounge and the dining room. The residents looked very well cared for and content. One resident was noted accessing different areas of the home without restriction. One resident told the inspector that staff treated them with kindness and respect. Another resident stated “the girls treat us with dignity”. Staff were observed knocking on doors and waiting for answer before entering to assist residents with personal care. Administration of Medication was checked and minor discrepancies noted were remedied immediately. DS0000003369.V335701.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are enabled to maintain links with their families and are also provided meaningful activities. The food is nutritious with varied choices available. EVIDENCE: The visitors’ book showed that the relatives and representatives regularly visit the residents. Residents spoken with confirmed that they had regular visitors. One resident spoken with said that the relatives visit every weekend. It was commendable to note that the provider went to pick up a relative from the end of the lane to enable the individual to visit their relative. It would not have been possible without the good gesture because of lack of transportation. The person was very complimentary about the home and the care given to their relative. The manager stated that staff undertake activities with residents based on the level of concentration and choice. Each resident has his/her brief history DS0000003369.V335701.R01.S.doc Version 5.2 Page 14 obtained from the resident or the relative. This is to enable the home to plan activities to suit their personality. On the day of the visit residents were seen around the table in the dining area and doing a painting exercise. One resident told the inspector that they always liked painting. The finished paintings were very good. Other activities undertaken by the residents include one to one sessions, sing along softball and walks in the garden when the weather is good. All activities undertaken were documented in individual care files. One relative felt that the residents would benefit from trips out to provide them with more stimulation. The provider stated at a discussion that the residents respond better in their familiar environment due to their level of concentration. The food looked nutritious and balanced, residents said they enjoyed their meal and those who had difficulty with feeding themselves were assisted with respect, dignity and sensitivity. DS0000003369.V335701.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for protecting residents and responding to their concerns are satisfactory. EVIDENCE: The home has a complaints policy, which is displayed at the home and included in each residents care file. The complaints procedure contains information about the Commission for Social Care Inspection to enable the residents to contact CSCI if they were not satisfied with the outcome of their complaint. The complaints procedure also contained details of how complaints would be dealt with and time scale. No complaints have been received by the home or the Commission for Social Care Inspection. There is the South Gloucestershire ‘No Secrets’ policy for dealing with suspected abuse. Six staff have received training on abuse of vulnerable adults Two newly employed staff members had Criminal Record Bureau checks however it was disappointing to note that one of the new staff members was employed without two suitable references. This has been discussed fully in standard 29. DS0000003369.V335701.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21 24 25 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents enjoy a pleasant, safe and homely environment and good standard of hygiene. EVIDENCE: A tour of the building showed that the environment was well maintained and suited to residents needs. The home’s standard of decoration is satisfactory and creates a comfortable environment for the residents. The garden was noted to be well maintained and had suitable garden chairs for the relaxation of the residents and their families during the summer months. The residents were found sitting in the communal areas and appeared relaxed in their homely environment. DS0000003369.V335701.R01.S.doc Version 5.2 Page 17 The home was found warm and well lit. Whilst the home was found to be generally clean it was noted that the flooring in the conservatory needed to be replaced to make the area safe and comfortable for the residents. The provider stated that the home has plans to repair the flooring as soon as possible in other to provided a more comfortable and safe environment for the residents. Residents’ bedrooms viewed looked homely, clean and had small items of personal possessions in individual rooms. Residents spoken with stated that they were happy with their bedrooms and felt safe at the home. The home’s Maintenance book was well maintained and appropriate action taken in relation to repairs to be carried out was recorded. There was evidence of regular hot and cold-water temperature checks and other routine checks in line with the Health and Safety legislation. The laundry area was found clean and tidy. DS0000003369.V335701.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28 29.30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents enjoy a good, warm relationship with competent staff. There are adequate numbers of staff to meet the needs of the residents. However the home’s recruitment procedure fails to offer protection to residents. EVIDENCE: On the day of inspection, there were adequate numbers of staff on duty to meet the needs of the residents. A record of one recently employed staff member was viewed and it was disappointing to note that one of the new staff members was employed without two suitable references before the person was allowed to commence employment in April 2007.The manager was reminded of the importance of ensuring residents are adequately protected through appropriate recruitment practices. An immediate requirement notice was issued for the home to obtain these references before the individual continued working at the home. In this way the residents are assured of a continued protection. The response to this requirement notice was received within the time scale given. DS0000003369.V335701.R01.S.doc Version 5.2 Page 19 The Criminal Records Bureau (CRB) check had been obtained as well as POVAFirst to enable the individual to work with an experienced staff member. Staff training records showed that staff have attended manual handling, first aid, food hygiene and medication administration training to ensure that they are competent to meet the residents’ needs. Two staff members spoken with on the day confirmed that they had received training on abuse and other statutory training. DS0000003369.V335701.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. 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. The home benefits from good leadership and management however, its practices do not fully protect the health and safety of residents. EVIDENCE: Mrs Margaret Hanney has been the registered manager of Park Farm House for a number of years. The residents and staff spoken with on the day of inspection stated that Mrs Hanney is a good manager. The comment card received from one relative summed up the general feeling of the individuals visiting the home. For example the a comment card states, “ I would like to add that Mr and Mrs Hanney and their staff care for my mum better than I ever could. All her needs DS0000003369.V335701.R01.S.doc Version 5.2 Page 21 are catered for with dignity and understanding. I can’t express enough how being a small home is so much better for people like my mum, with dementia and who need to feel safe and secure. I can see for myself when I visit weekly that, to my mum Park farm House is her home and her family, as these are the kind caring people who look after her so well everyday”. Mrs Hanney stated that a senior carer is to commence a level 4 National Vocational Qualification (NVQ) in management and Care and Registered Managers Award to enable the individual to take over the management of the home when Mrs Hanney retires. The provider of this training visited the home on the day of the visit to meet with the manager and the senior carer to discuss the details of this training. This development will be closely monitored before and during the next inspection. Whilst complimentary information had been received about the home from different sources, a relative of a resident that recently moved to a more appropriate environment due to an increase in need contacted the Commission regarding the management approach leading to this placement. This was discussed with the providers and the manager would ensure that in future a different approach would be used to ensure that families are supported in a more friendly and sensitive way. Documentation in relation to health and safety procedures were in date, the fire logbook evidenced that the last fire drill was on 19/04/07. However it was noticed that the home had not undertaken a generic risk assessment to cover all areas of the home in order to minimise / eliminate hazards and protect the residents staff and visitors. Records evidenced that staff received regular supervision to ensure that they are supported in their responsibility of providing personalised care to the residents. In relation to Quality Assurance the manager stated that the home receives regular feed back from relatives, doctors, health professionals and other visitors about the services provided by the home. The manager also stated that the home has an open door policy to enable residents, relatives, friends and other visitors to approach the management at any time to talk about any issues, confidential or otherwise. The home’s policies and procedures were not available for review on the day of inspection and clearly were not accessible for staff to refer to at all times including emergency situations. An immediate requirement was made for this to be brought to the Commission for verification. DS0000003369.V335701.R01.S.doc Version 5.2 Page 22 The home’s policies and procedures were brought to the Commission for Social Care Inspection for verification as required on the day of the visit. Polices and Procedures noted include Whistle-Blowing, Medication. Protection of Vulnerable Adults from Abuse, manual handling, and Infection Control. However, the home must ensure that identified missing statutory policies and procedures from the home are developed to ensure that the residents are adequately protected. All residents’ records were securely locked away. DS0000003369.V335701.R01.S.doc Version 5.2 Page 23 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 3 3 2 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 X X X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 2 DS0000003369.V335701.R01.S.doc Version 5.2 Page 24 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. 2. Standard OP38 OP8 15 Regulation Requirement Undertake a generic risk assessment to protect the residents. Develop care plans for all residents and specific care plans for identified residents. Send these to the CSCI by 16/05/07. REQUIREMENT IS REPEATED FROM THE PREVIOUS INSPECTION OF 16/05/06 Ensure satisfactory recruitment documentation is in place for identified staff member and subsequent new staff. THIS REQUIREMENT IS REPEATED. Ensure that newly employed staff members have full induction before working with residents. Ensure that an identified resident is referred to appropriate health professional (CPN) to support the home to develop strategies to meet the individual challenging needs. Furthermore put risk assessment in place to protect the individual staff and other residents. Timescale for action 15/06/07 16/05/07 3. OP29 19 (1) (c) SH 2 paragraph 5 18 16/05/07 5 OP30 15/06/07 4. OP10 13 30/06/07 DS0000003369.V335701.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP33 Good Practice Recommendations Develop good communication system with family and friends in relation to change in needs of the residents and other matters of concern. DS0000003369.V335701.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 DS0000003369.V335701.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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