Inspection on 12/09/07 for Park Farm Lodge Care Home

This inspection was carried out on 12th September 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Park Farm Lodge Care Home 31/05/06

Park Farm Lodge Care Home 22/11/05

Park Farm Lodge Care Home 27/06/05

Park Farm Lodge Care Home 25/01/05

Park Farm Lodge Care Home 08/06/04

Park Farm Lodge Care Home 19/11/03

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Park Farm Lodge Care Home Park Farm Road Tamworth Staffordshire B77 1DX Lead Inspector Mr Keith Jones Key Unannounced Inspection 12th September 2007 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 Lodge Care Home DS0000045160.V340503.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 Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park Farm Lodge Care Home Address Park Farm Road Tamworth Staffordshire B77 1DX 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) 01827 280533 01827 288544 park_farm_lodge@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Ltd Mrs Laura Ann McCormick Care Home 80 Category(ies) of Dementia (40), Old age, not falling within any registration, with number other category (40), Physical disability over 65 of places years of age (40) Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide personal care (with nursing) and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories:old age not falling within any other category, OP, 40; physical disability - over 65 years of age, PD(E), 40; dementia - over 50 years of age; DE, 40. The maximum number of service users to be accommodated is 80. 2. Date of last inspection 31st May 2006 Brief Description of the Service: This is a purpose built care home with nursing which can accommodate 80 service users in the above categories. The home is situated on the outskirts of Tamworth and there is a bus stop outside the main entrance, facilitating easy access for visitors. Local towns are accessible by car or public transport. There are two levels, which can be accessed by lifts or stairs. There are wide corridors with grab rails fitted throughout the building. The gardens are accessible by wheelchairs and are well maintained, appropriate seating facilities are provided. There is adequate communal space for service users and all bedrooms are single occupancy with en suite facilities, they are in excess of 10 sq. m of useable space required. Bathrooms and toilets are appropriately situated and bathroom and toilet doors are painted in alternative colours, which assists service users in locating them. The interior of the property is well maintained; clean and the décor is set to a good standard. Communal areas are spacious and comfortable. Small, quieter sitting areas are available on both floors. Adequate parking is available to the front and side of the property. Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted over one day, by one inspector, with the Care Manager, two Clinical Managers and the Regional Manager of Four Seasons in attendance, in a professional and cordial atmosphere. The Inspector acknowledged receipt of the prepared Annual Quality Assurance Assessment and 7 comment sheets, mainly complimentary, with some useful advice. Comments received from residents and families, via written surveys about staff and life at the home, and the manner in which they are cared for were of a positive nature: “Always phone me and keep me informed”, “I get lots of attention”, “Spotlessly clean, staff kind and considerate”. Surveys were also received with comments about the home’s services, activities and décor, none were over critical, and all were shared with the management. The last inspection report was discussed, and it was noted that there were no outstanding requirements or recommendations. On the day of inspection there were 66 Service Users in residence, 36 with physical care needs and 31 with mental health needs. A full case tracking of five Service Users yielded a valuable insight of policies in action. Records and a sample review of the administrative arrangements confirmed effective management. Weekly fees range from £373 to £699. A tour of the Home allowed free and open access to all areas for inspection. The opportunity was taken to speak with a number of residents, relatives and members of staff. Service users and staff took an active role in the inspection process and contributed to the subsequent report. Throughout the entire inspection a sense of familiar confidence pervaded into all aspects of daily activity expressed by those people met. A review of the administrative arrangements confirmed solid practice and effective management. A full verbal report was offered at the end of the inspection to the Care Manager, Regional Manager and the Clinical managers. Overall the attitude in meeting caring and organisational demands is commendable, with forward thinking, planning and application, contributing to a very satisfactory inspection. Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 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 Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 and 5 The quality in this outcome area is “good.” This judgement is based on the examination of the Homes policies, procedures, practices and discussions with management. The Provider ensures that the admission process is a reflection of a joint understanding that residents are aware, and that staff are able to meet expectations, to realise a comfortable transition. The Home has demonstrated their commitment to promote a partnership of care, to meet the objectives of providing a home to meet individual needs. EVIDENCE: The Four Seasons’ produced Statement of Purpose/guidelines reflects an expression of philosophy, and has been well established in representing the foundation on which the home operates upon. It presents an appropriate description of the Home’s aims and objectives, philosophy of care and terms Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 9 and conditions. Requirements prescribed in Schedule 1 are addressed, presenting Four Season’s policies, with Park Farm Lodge’s identity. The contract document reflects changed circumstances and conditions, including an identification of allocated bedroom agreed. Case tracking of five individual residents clearly identified that the Care Manager, or her deputy, at the point of reference, conducts the pre-admission assessment. The documentation was examined and found to be comprehensive, providing a solid foundation for progressive care planning. This assessment is produced with the full involvement of service users and family, allowing them to influence the direction of care. The assessment initiates the process of care, each individual having a plan of care, which includes a daily living plan and longer-term goals and outcomes. The detailed assessment was examined, a ‘Dependency Assessment Rating Tool’, and was found to collect a full profile of physical and psychological needs, as well as social, cultural and environmental circumstances. Following an assessment the assessor determines the suitability of the application in view of the facilities available, and at the capacity of the home, to manage the individual and any special needs. Likewise the applicants are informed of those facilities and are encouraged to seek clarification concerning the general and specific services available for the prospective service user. Any special needs of the individual were discussed fully and documented, ensuring their individual needs would be met. Case tracking confirmed that a valuable exchange between Service Users and assessor took place and resources made available. These resources were seen to be an appraisal of staffing skills, equipment and general environment. From discussions with staff and residents it was evident that prospective residents and their relatives are able to visit and assess the quality, facilities and suitability of the Home at any reasonable time, to meet with staff and management. At all times relatives are involved in the process. The management style is highly personable and inclusive, generating a warmth and comfortable environment. Relatives are welcome to view the facilities and participate in the planning and assessment of care. Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 10 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 and 11 The quality in this outcome area is good. This judgement is based on the examination of five care plans, discussions with residents, staff, managers, general observations and the Home’s medication system. The care assessment, planning and review system is a highly organised, yet personalised process offering meaningful and valid documentation of care administered. A broad vision of needs is addressed through the care planning process, meeting personal and health needs. It is recognised that this reflects an individual profile of needs, discussed fully with family. The provision of a secure and safe medicines administration is managed efficiently. The Inspector was impressed with the confidence and closeness within the Home of staff, residents and visitors, and the mutual respect that prevailed. EVIDENCE: Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 11 Care records and case tracking clearly showed that this standard is well met, maintaining a high quality process of assessment. The pre-admission assessment represented the foundation for a well-considered and detailed care planning process. A comment from a relative “ They have handled my mothers care very well”, reinforced this standard. A profile of the service user’s social, physical and psychological status offered an individual plan of care, based upon activities of daily living, has been implemented and frequently reviewed, a ‘Dependency Assessment Rating Tool’. Each service user’s health, personal and social care needs are carefully assessed in an individual plan of care that is reviewed monthly, including service users and relatives views, to reflect their changing needs. That review is more frequent, dependant upon the individual’s needs and clinical condition. The strength of purposeful planned care lies within the frequency of the review process in monitoring and adapting care profiles. As is appropriate, a checking chart ensures that constant monitoring of high dependency residents is carried out. A daily report is maintained to control monitoring, and offer a very comprehensive account of care and service given. Risk assessments were carried out on an individual basis and frequently reviewed. Case tracking confirmed the extent that the carefully prepared, and well-recorded care plans were appreciated by residents and relatives alike. Tissue viability, continence, psychological and special needs are assessed and documented, along with nutritional screening, hearing and sight tests as appropriate. The GP service is thorough and supportive; through this service, arrangements are made to provide professional support. Continence is assessed on admission and promoted within the plan of care, and there was evidence that resident’s nutritional needs, and weights were frequently reviewed. Care staff maintain all aspects of service users personal care, overseen by the Clinical Managers on a daily basis. The administration of medicines adheres to procedures to maximise protection to service users. The storage was secure with satisfactory added security for controlled drugs. A controlled drug register was examined and found to be in order. Each service user has the opportunity of their own lockable facility in their bedrooms on request. Oxygen is effectively stored in the clinic room. The Statement of Purpose, admission assessment and care plans are geared to engender a sense of individuality and privacy. These policies are reinforced with a staff induction programme and supervised practice. Case tracking confirmed that the policies were implemented, with all residents spoken with being complimentary of the degree of respect given, by each and every member of staff. The inspector observed the free, courteous interaction Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 12 between service users and staff based on a level of confidence of mutual trust and respect. There was also an observed knowledgeable, and positive attitude towards residents and feedback from the residents: “Staff are good, we are well looked after, and “ It’s very comfy”, and also “ food not as nice”, “life a bit boring”. Visitors revealed: “Staff always phone me with anything out of the ordinary”, “Nan is safe, there are no visiting restrictions.” Relatives have freedom of visiting, emphasising on the importance of maintaining social contact. Adequate privacy policies exist for all toilet/bathroom areas and bedrooms. Regular resident and family meetings are regarded with respect and minuted. Useful exchanges were seen to be an outcome. An annual customer survey was examined and seen to offer a very valuable insight into expectations and objectives. It was acknowledged that there exist extremely good working relationships with District Nurses and General Practitioners for the Home. Two senior members of staff are experienced in ‘Dementia Care Mapping’, a form of observing interactions between staff and residents. The policy and procedure on care of the dying and death were in place with the full knowledge of both service users and relatives. Individual spiritual persuasions were documented and individual diversity respected at all times. Church of England services are offered each Wednesday afternoon, and Roman Catholic services given as requested. Relatives are welcome to stay as long as they liked in times of stress, including overnight stay. The Inspector was impressed with the confidence and closeness within the Home of staff, residents and visitors, and the mutual respect that prevailed. Park Farm Lodge Care Home DS0000045160.V340503.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 and 15 The quality in this outcome area is good. This judgement is based on discussions with residents, staff and examination of records in relation to social activities undertaken and general observations during to course of the inspection. Residents informed the inspector that they were extremely satisfied with the way the Home met their social needs, encouraged their family and friends to visit, allowed them to take decisions that affecting their lives. Routine is seen as flexible to acknowledge individuality, yet maintain a focal point for service users to latch on to without dictating events. Service users’ life-styles and interests are recorded in their care plan, discussed with their relatives prior to admission, and documented as far as possible to enhance a position of supported independence. Personal choice and relative self-determination are respected in policy and action. Those who wish to bring in personal possessions are encouraged to do so. Choices were available for every aspect of daily living and menus provided a varied and good choice of food available on a new four weekly programme. Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 14 EVIDENCE: From talking to residents and staff it was pleasing to report a continuing daily routine that is flexible and non-institutionalised, offering choice for meal times, personal and social activities including recognition of varied religious needs. The issue of diversity was discussed with the manager and staff, and it was evident that individuals’ needs would be well researched, and met. At pre-admission the resident’s’ personal interests and customs are determined, and where possible accommodated within the routine of the Home. That routine is seen as flexible; to acknowledge individuality, yet maintain a focal point, without dictating events. Discussions with residents and staff clearly identified a relaxed and informal atmosphere in which the service user’s needs were paramount. The Home employs an activity coordinator in social activities for both floors, seen as an integral part of care. This is applied within the care planning process as an important aspect of care, as evidenced in examination of records, activities schedule and discussion with staff. Active consideration is being given to improve this resource, linking in to a well-being philosophy to facilitate closer contact between care and activity. The Home has been awarded a grant to improve sensory therapy equipment, to be disseminated through the Home. Relatives and friends are encouraged to maintain social links as part of the planning of care. Comments received from relatives confirm their appreciation and involvement with the progress of their loved one’s health and social status; a relative commented: “Good management of mum’s dementia’”. Residents are encouraged to exercise choice and control over their life as far as is possible, and are actively encouraged to bring into the home personal possessions. The tour of the Home demonstrated a high degree of expressed individuality in each of the bedrooms inspected. The Home operates a secure system of handling resident’s monies, with only small amounts of petty cash, which was efficiently handled through the administrator’s office, and subject to internal inspections/audits. It was pleasing to see the high standards of catering at Park Farm Lodge, offering an excellent service, to which all service users spoken to were complimentary of all aspects of quality. A menu on a four weekly cycle offered a wholesome, varied and excellent choice. Individual preferences were recorded in assessment and conveyed to cook, who met with, and discussed their requirements. It was confirmed that the cook knew each service user, and some of the relatives. An excellent lunch was served during inspection, Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 15 served in pleasantly furnished and clean dining rooms. Staff were seen to offer discreet assistance to those who required it. The choice of dining room, lounge or bedroom was at the discretion of service users. The dining area on the first floor would benefit from a review of furnishing and décor to enliven and present a more conducive environment. The kitchen was inspected and found to present a well equipped and organised area. All fridges and freezers were well maintained and checked daily by the kitchen staff. A cleaning schedule was in place and seen to be up to date and accurate. COSHH notices were in evidence with cleaning chemicals secure, appropriate and under control. Park Farm Lodge Care Home DS0000045160.V340503.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, 17 and 18 The quality in this outcome area is good. The Home had a meaningful complaints policy, clearly identifying the CSCI as a resource to approach with a complaint or grievance. No complaints had been received via the Commission since the last inspection. Service users’ legal rights are protected by the systems in place. Staff induction and in-house training programmes clarified the responsibilities of all staff in their daily contact with service users, especially their privileged position in protecting service users from abuse, of all natures. EVIDENCE: Service users’ legal rights are protected by the systems in place in the home to safeguard them, including their contract, the continual assessment of care planning and policies in place i.e. the complaints procedure. The complaints policy was seen and records examined. There were few complaints, which would be better dealt with through a ‘record of concerns, complaints and allegations’, to record residents and families concerns in a meaningful and effective manner. On discussions it was evident that any small matters were handled immediately, discretely and to the satisfaction of all concerned. The overall policy of openness and transparency was acknowledged. Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 17 All service users had received information on the procedure to complain, including reference to the CSCI. This process was evidenced on examination and case tracking as previously reported upon. Discussion with the Care Manager confirmed that there is satisfactory evidence of a protocol and response, to anyone reporting any form of abuse, to ensure effective handling of such an incident. Staff induction and in-house training programmes clarified the responsibilities of all staff in their daily contact with service users. Park Farm Lodge Care Home DS0000045160.V340503.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): 19,20,21,22,23,24,25 and 26 The quality in this outcome area is “good.” This judgement was based on discussions with service users, staff and a tour of the premises. The Home is well appointed to meet the needs of an elderly population of service users in providing a safe and comfortable environment. On inspection, bedrooms were highly personalised with most displaying service user’s own furniture, and with personal belongings, the outcome is a comfortable and familiar private domain that reflects the service user’s wishes. All communal areas are of a good standard, offering social as well as private reflection, as the mood takes. The overall environment was found to be safe for service user’s comfort within risk assessed limits. There is evidence of an awareness of health and safety issues being high on training and supervision priorities. Individual rooms are presented as personalised and inviting individual domains. The domestic services in the home were seen to be of a high standard, with no evidence of unpleasant smells or unsightly debris anywhere throughout the inspection. The Home continues to present a clean and pleasant, odour-free atmosphere, much to the credit of staff. Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 19 EVIDENCE: External access is satisfactory for visitors, service users take advantage of attractive gardens and grounds; pathways were safe and recently attended to by the gardener . On admission the Care or Clinical Manager assesses each individual service users’ needs for equipment and necessary adaptations. Internal access was facilitated with ample fittings of hand and grab rails, in adequate, well-lit and airy corridors. Wheelchair access was satisfactory throughout all areas of the home. Bedrooms were well maintained to meet service user’s personal preferences. There are adequate numbers of good quality nursing, ‘profiling’ beds available. On inspection most bedrooms were highly personalised, with some displaying service user’s own furniture, and most with personal belongings. It is the policy that on bedrooms becoming vacant that each room is reappraised for redecoration. There is throughout a good standard of furnishing complimented with a variety of personal belongings. Some of the original furniture is ready for replacement. A locked facility and lockable bedroom doors were made available on request, following suitable risk assessment. The evidence seen on inspection of service user’s rooms, and on discussion with the individual resident and family, assured that this standard was well met. The Care Manager is to review the type of lock available to maximise secure access and minimise risk. PAT testing of all electrical equipment was up to date. All communal areas are of a high standard, offering social as well as private reflection, as the mood takes. Eight lounge areas allow activities to be presented in a very pleasant, animated area of the home, or a quiet area with pleasing furniture and fittings of good quality. A designated smoking lounge is identified on each floor. The main dining areas were very pleasant, although the dining area on the first floor would benefit from a review of furnishing and décor, to enliven and present a more conducive environment. The external and internal environment was well maintained and secure. Heating and ventilation were found to be satisfactory and lighting was domestic in style. All rooms had on-suite facilities, and aids, adaptations and equipment were available throughout the Home. The standard of cleanliness was of a good standard throughout. Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 20 Kitchen presentation showed good standards of cleanliness and evidence of sound food hygiene practices. Maintenance of records reflect the good standards observed. The extensive laundry was well organised and equipped to a good standard, the flow of laundry through the process enhance cross infection control. Red Alginate linen bags are available and widely used. Notices regarding chemical handling in the areas that store chemicals are displayed. The external and internal environment was well maintained and secure. The Care Manager is to provide the Inspector with a development plan for 2007/08/09. A risk assessment inventory for the building has been commenced and should be finalised in concert with the fire risk assessment. Heating and ventilation were found to be satisfactory and lighting was domestic in style. Aids, adaptations and equipment were available throughout the Home. Fire equipment was inspected and seen to be serviced and up to date. During the inspection a fire alarm triggered a full response from the Fire Service and staff on duty. The action was seen to be efficiently carried out and organised, responses were timely and calmly executed. The home presented a clean and pleasant, odour-free atmosphere, much to the credit of staff. Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 21 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 The quality in this outcome area is “good.” This judgement was based on the examination of staff files, working rotas and discussions with staff. The staffing levels in relation to the number of service users in residence and their dependency level was suitable to meet the needs of residents. Staffing stability has been maintained with consistent levels to ensure equilibrium between numbers, skills and qualifications, with a strong presence of long serving experienced staff. Care bank are occasionally used, agency rarely, with agreed overtime and flexible rostering to accommodate shortfalls. The management have established a comprehensive procedure for interview, selection and appointment of staff. The thoroughness of staff selection has a significant effect upon the provision of cares to ensure protection of service users. All staff receive training in care issues within the home from registered nurses and external trainers. EVIDENCE: Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 22 The inspection was conducted with the care manager and unit managers, and it was confirmed that there were 66 service users in residence on the day of inspection, 31 EMI and 35 with physical disability. Three weeks of duty rotas were available, inspected and staffing levels were seen to be satisfactory. The overall general skill mix and numbers of staff working in the home meet the needs of the service users. It was acknowledged that the Home has been showing a steadily improving bed occupancy for several months. Staff levels ere seen to be appropriately adjusted as needs arose. The daily care staffing rota showed adequate balance between skills, qualifications and numbers to provide a foundation for a good standard of care. Shifts are supported with full participation of unit managers, with the Care Manager supernumerary. Agency coverage has been rarely used since the last inspection; overtime and flexible rostering meet shortfalls. An average daily coverage was recognised for each unit: EMI: a.m - 2 RN 5 carers p.m - 2 RN 5 carers N.D - 1 RN 3 carers General; a.m - 2 RN 4/5 carers p.m - 1 RN 3/4 carers N.D - 1 RN 3 carers The catering, domestic and laundry hours were determined and found to be appropriate for the size of the home and the needs of the residents. The home has an activity organiser for 30 hours per week. The care manager emphasised the Home’s commitment to training and to achieving targets for NVQ level 2. There are 12 staff with NVQ level II and level III. There are 22 certificated first-aiders in the home’s staffing establishment. Dementia care and conflict resolution training are well established, with two senior staff trained in Dementia Care Mapping. The Care Manager was advised to seek full training and procedural guidance on the Mental Capacity Act due to be fully implemented in October 2007. Five staff files were sampled and found to be well organised and up to date, following a review of procedures. It was evidenced that CRB checks have been made and contracts of employment are up to date. Ongoing personal and training records were kept secure in accordance of the Data Protection Act 1998. Policy clearly states an equal opportunity position. Three on-duty members of staff were interviewed, each expressing their working conditions openly and with confidence. Each individual was complementary as to the level of training and supervision they receive. Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 23 Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37 and 38 The quality in this outcome area is good. This judgement was based on discussions with the Regional Manager, Registered Manager and Clinical managers, the examination of the Home’s policies and procedures with regards to the effective management of the home, with general observations during the process of the inspection, and discussions with service users and staff. The care manager Laura McCormick offers a considerable resource of experience and skills, which are reflected in the high standing in which Park Farm Lodge is held. The inspector was impressed by the openness and confidence in the observed interactions of staff, relatives and service users. The relationships were seen to be of mutual trust and respect. Evidence was secured to confirm a quality monitoring system has been well maintained, based upon audit of standards, care plans and feed back from service users and relatives. Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 25 On-site inspections offers evidence of a management firmly in control, well organised and prepared to facilitate meaningful, delegated responsibilities to an efficient care management team. EVIDENCE: The Registered Providers and Care Manager have continued to demonstrate competence in establishing a solid policy and procedural foundation that has been implemented, to achieve a high standard of set aims and objectives. An experienced senior Nurse, with a professional portfolio of practical and managerial experience, has recently completed her Registered Managers Award. She is ably supported by well-qualified, experienced Clinical Managers, and senior nursing and care staff, all of whom represent an effective care management team Staff meetings are held regularly in which staff are encouraged to participate fully in the management and direction within the home. The inspector observed at first hand the confident interrelationship that exist, not only between management and staff, but also between staff and residents. Evidence was secured to acknowledge achievements, ongoing and planned objectives. Involved within this process are the views of residents and relatives, confirmed at case tracking and informal discussion. There was strong evidence of openness and honesty in speaking with service users, relatives and staff, in which day to day events and episodes are freely discussed. Evidence was secured to confirm a quality monitoring system has been introduced, based upon audit of standards, care plans and feed back from service users and relatives. The most recent Annual Customer survey was examined and recognised as a most helpful tool in quality appraisal. Standards are discussed at staff meetings, daily reports, direct observation involvement and one to one staff meetings. 6 comment forms from residents and relatives were received and discussed. The Provider was asked to prepare a development plan for 2008/09 to encompass perceived changes and objectives. The Care Manager was advised to continue in preparing an inventory of risk for all areas of the Home, to meet the ongoing standards for fire protection, Health and Safety, and to establish a firm foundation for development planning. The procedures manual was randomly examined, and found to offer a very comprehensive reference. Whistle blowing, Health and Safety and Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 26 Safeguarding policies were examined and found to be informative and up to date. All procedures are dated, requiring continual upgrading. Fire safety remains high priority for all staff evidenced in routine maintenance checks, regular fire drills and frequent staff training sessions are organised. Policies have been reinforced in accordance of requirements made at the last fire inspection. Discussion with the Care Manager indicated that supervision sessions and individual training programmes are areas that with continuing improvements, will enhance the desired impact on quality of service. A sample of administrative, maintenance and care records were examined and found to offer an accurate reflection of a service committed to providing a safe and comfortable environment for elderly service users. This was confirmed by inspection of service agreements for emergency call system, PAT and water supply. Accidents were seen to be addressed, risk assessed, actioned and recorded in an effective way, with access to Riddor if needed. A three monthly audit is established. No serious accidents have been recently reported. The administration and management of the home is efficient, uncomplicated and sensitive to the needs of service users. Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 27 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 4 4 3 x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 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 4 4 3 3 3 3 3 3 Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 28 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. Standard Regulation Requirement Timescale for action 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. Refer to Standard OP30 OP24 Good Practice Recommendations That senior staff attend Mental Capacity Act training courses. Review bedroom and communal furniture for repair/replacement. Provide a development plan for 2007/08/09 That a full unit risk assessment programme be updated. All service area doors to be secured when not in use, and stores to be safely organised. The procedure for handling safeguarding issues be DS0000045160.V340503.R01.S.doc Version 5.2 Page 29 3 4. 5 6 OP33 OP19 OP19 OP18 Park Farm Lodge Care Home upgraded. 7 8 9 OP16 OP19 OP21 The complaints book be established to accommodate concerns, complaints and allegations. That consideration be given to upgrade the EMI unit dining area. That bathrooms be considered for early upgrade. Park Farm Lodge Care Home DS0000045160.V340503.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Birmingham Local Office Commission for Social Care Inspection 1st Floor, Ladywood House, 45-56 Stephenson Street, Birmingham B2 4UZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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