Inspection on 17/05/06 for Park Farm House

This inspection was carried out on 17th May 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 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 15/05/07

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 17th May 2006 09:00 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 Park Farm House DS0000003369.V292494.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. Park Farm House DS0000003369.V292494.R01.S.doc Version 5.1 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 9374500 Mrs. Margaret Joan Hanney Mr. Jeffrey Hanney Mrs Margaret Joan Hanney Care Home 7 Category(ies) of Dementia - over 65 years of age (7) registration, with number of places Park Farm House DS0000003369.V292494.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th December 2005 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. Park Farm House DS0000003369.V292494.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced Inspection 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 current and best practice is followed at the home. At the last inspection three requirements were made in relation to different areas of service provisions at the home. It was pleasing to note that the home had made tremendous efforts to ensure that all requirements made were met. However, immediate requirements were made, in relation to developing specific care plans for identified residents, recording of accidents to residents, and ensuring accurate recording, administration and dispensing of Controlled drugs, also ensuring that all given medication are signed for. The Manager and staff were seen, interacting with the residents, in a respectful, dignified and sensitive manner. An atmosphere of strong teamwork was noted throughout the home. A quick tour of the building was undertaken and a number of records were viewed. One resident, three staff members and two relatives were spoken with during the inspection. What the service does well: What has improved since the last inspection? Park Farm House DS0000003369.V292494.R01.S.doc Version 5.1 Page 6 A review of the last inspection requirement in relation to staff supervision, training of staff on First Aid and accessibility of records have been met. In addition the long-standing dispute with the neighbour in relation to right of way had been resolved. 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. Park Farm House DS0000003369.V292494.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Park Farm House DS0000003369.V292494.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Residents are assessed before admission to the home and are provided with contract of their stay at the home EVIDENCE: Evidence from the care files viewed showed that the residents have been in the home for many years. One relative met with on the day stated that “mum is settled here” and have been in this home for six years. Another relative stated at a telephone conversation that their person was assessed before admission to the home; they were offered a trial visit and also given a contract detailing the fees to be paid Park Farm House DS0000003369.V292494.R01.S.doc Version 5.1 Page 9 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): 7,8,9,10,11. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents’ needs are assessed; Doctors and other health professionals are involved in their care, however the home fails to protect the residents through lack of care plans and unsatisfactory drug administration practices. EVIDENCE: Three residents’ care plan documents were checked. The files contained evidence of identified needs however lacked clear information and direction to enable the staff to deliver appropriate care according to the residents needs. One resident’s care file reviewed evidenced that there was no care plan in relation to a medical condition and how it is being managed at the home. There was no risk assessment on how the resident is assisted from chair to bed and when care is provided in bed. Furthermore, a resident with a challenging behaviour had different entries on wandering and had no care plans on how these conditions were being Park Farm House DS0000003369.V292494.R01.S.doc Version 5.1 Page 10 managed. An immediate requirement was made for care plans to be developed for all the assessed needs to ensure that all the needs are adequately met. There was evidence that the General Practitioner (GP) and other health professionals are involved in meeting the health needs of the residents. One resident spoken with stated that staff respected them and provided them with good care. One relative spoken with stated, “the home is good and the residents are well cared for”. The Commission received regulation 37 Notifications in relation to residents admitted to hospital due to medical conditions. Review of Medication Administration at the home evidenced that the home failed to protect the resident in relation to storage, and recording of Controlled drugs. An immediate requirement was made for the home to remedy this situation. An action plan of how this requirement was met was received at the Commission on the required date. Staff interviewed were aware of the confidentiality policy and were able to demonstrate knowledge of how to care for residents that are terminally ill also at their times of death. One resident was ill and was being cared for in bed, looked well cared for. The relative stated that the home regularly updated them on the individual’s condition. Park Farm House DS0000003369.V292494.R01.S.doc Version 5.1 Page 11 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): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are enabled to maintain links with their families; they are also provided nutritious meals and meaningful activities. EVIDENCE: Staff are mindful of the type of activities to provide for the residents in relation to their capabilities. Each resident is assessed for the timing of provision of care as far as is practicable, their wishes are considered and where it is not possible the relatives and /or advocates are involved to ensure that personalised care is provided. One staff spoken with stated that some times the activities are planned on what activities that all residents can enjoy. Recorded activities included music movement and dancing, table skittles, painting, chair aerobics and soft-ball. One relative interviewed stated, “mum likes music and responds to personal interaction with staff”. Staff were noted interacting with the residents in an informal and personalised manner. One resident told the inspector that it was her birthday the day before, she had a lovely cake and she enjoyed the day. The visitors’ book showed that their relatives and representatives regularly visit the residents. Park Farm House DS0000003369.V292494.R01.S.doc Version 5.1 Page 12 The lunch on the day looked nutritious and balanced and the residents spoken with stated that they enjoyed their meal. One relative spoken with stated that “mum is unable to feed herself, staff feed her and she seems to enjoy the food” The kitchen was found clean and staff have attended basic food hygiene to ensure that residents are adequately protected Park Farm House DS0000003369.V292494.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are enabled to complain and are protected from abuse. EVIDENCE: The home has appropriate procedures in place for the management of any complaint at he home. There is no recorded complaint and no complaint had been received at the Commission for Social Care inspection. There is evidence that staff have attended Protection of Vulnerable Adults from abuse training. Whilst the home has protection of Vulnerable Adults policy, there was no evidence of the South Gloucestershire Council document on how to report incidents of suspected abuse. It was agreed that this document be obtained to ensure that the correct procedure is followed. Staff are aware of the Whistle Blowing Policy and are able to report incidents of abuse without reprisal Park Farm House DS0000003369.V292494.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 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 suitable, safe and well-maintained environment. EVIDENCE: During a tour of the premises, all parts of the home were found clean, warm, free from unpleasant odour and well maintained. Clinical waste is correctly disposed of and measures are in place to support appropriate infection control. It was noted whilst walking about that one of the rooms is currently vacant. The manager stated that this was due to repair work to be carried out following a water leak. 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 garden is walled to provide extra privacy and security to the residents. Park Farm House DS0000003369.V292494.R01.S.doc Version 5.1 Page 15 At the last inspection a concern was raised in relation to a long-term dispute between the providers and their neighbour in relation to access to the home. The manager stated that the dispute had been resolved and that the home had been granted access by the court after a very lengthy process. This verdict would enable the providers to concentrate their efforts to provide high quality care for the residents as well as maintain stability at the home. Park Farm House DS0000003369.V292494.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): 27,28,29,30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents are provided with sufficient numbers of staff to meet their needs however the home fails to offer adequate training to its staff to protect the residents. EVIDENCE: Two staff members were on duty on the day of inspection as well as Mr and Mrs Hanney, the providers. Staff spoken with stated that there are always two staff members on each shift during the day and one staff member on night shift. The rota reviewed on the day confirmed that two staff were on duty from 830 am –1300, two staff from 1300 - 1700, two staff from 1700 – 2100, one staff from 2100-0830. Evidence from the staff training records showed that staff have attended training on First Aid, Basic food Hygiene and Manual Handling. One staff member spoken with confirmed that they have completed National Vocational Qualification (NVQ) at level 2. However, there was no evidence that staff have attended Dementia Awareness training and dealing with challenging behaviour, to enable them to provide appropriate care to the residents. A requirement had been made for staff to attend this training. Park Farm House DS0000003369.V292494.R01.S.doc Version 5.1 Page 17 Whilst it was evident during discussion that staff are aware of the needs of the category of residents and acknowledge that everyday is different (the ladies rely on us) specific and comprehensive training on dementia remains the cornerstone for meeting the needs of these residents. The two staff on duty on the day were noted to be very professional in their observations and took appropriate action following specific care needs of the residents. Records of two recently appointed staff evidenced that appropriate recruitment procedures were followed as well as appropriate induction to enable the staff to familiarise themselves with needs of the residents and the home’s general routine before assisting the residents with personal care. Park Farm House DS0000003369.V292494.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 31,32,33,35,36,37,38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home is well managed, however, it fails to protect the residents by lack of accident recording. EVIDENCE: Mrs Margaret Hanney remains the registered manager of Park Farm House. Mrs Hanney has attended different training courses to enable her to support the staff to provide good standards of care for the residents. At a discussion Mrs Hanney stated that she had attended a First Aid course, intermediate certificate course in food hygiene. Monitored Dose System (Medication) and is to commence the Registered Managers Award shortly. The record also showed that the manager had attended a course on “Supporting People with Dementia” in 1999, this course needs to be updated in order to raise awareness of current issues in dementia. Park Farm House DS0000003369.V292494.R01.S.doc Version 5.1 Page 19 Staff spoken with stated that the manager is approachable and would listen to concerns raised. One relative stated that the manager is “approachable and takes interest in the care of the residents”. Another relative stated, “I can’t praise the manager and the home enough”. Documentation in relation to health and safety procedures including fire logbook and service records were in date, however, review of the accident book showed that two accidents to residents on 6/01/06 and 17/04/06 were not recorded. A requirement was made in line with the legislation Records evidenced that staff received regular supervision; staff members confirmed this during discussions. Policies and procedures are in place and updated. The manager was unavoidably absent half way through the inspection and was unable to discuss ways used by the home to monitor the quality of its services. This will be reviewed at the next inspection. An accessibility issue, which was identified at the last inspection, had been resolved. This had been discussed earlier. In relation to concern raised by the home about poor performance by a staff member, the manager stated that the matter is in hand and a meeting with the staff member had been organised for Thursday night. Residents’ records were securely locked away. Park Farm House DS0000003369.V292494.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. 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 3 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 1 9 1 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X 3 3 2 Park Farm House DS0000003369.V292494.R01.S.doc Version 5.1 Page 21 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. 2 Standard OP9 Regulation 13 Requirement Timescale for action 17/05/06 4 3 1 OP38 OP30 OP8 Schedule 4 18 15 Controlled drugs must be appropriately recorded, dispensed and administered. All medication given must be signed for. All accidents to the residents 17/05/06 must be recorded. Provide training on dementia and 17/06/06 challenging behaviour for all staff. Develop care plans for residents 18/05/06 and specific care plans for identified residents. Furthermore residents must be risk assessed for manual handling. 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 Park Farm House DS0000003369.V292494.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Park Farm House DS0000003369.V292494.R01.S.doc Version 5.1 Page 23 - 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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