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Inspection on 31/01/06 for Park Hills Nursing Home

Also see our care home review for Park Hills Nursing Home for more information

This inspection was carried out on 31st January 2006.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

The manager has addressed the requirements made at the last inspection and has improved the quality of the home`s care planning documentation. Care records identify resident`s needs and care interventions are more detailed. Wound care documentation has improved. Records of staff training had improved and corporate induction records were available. Fire safety records were recorded including fire drills but records of all staff participating in the drills were not available.

What the care home could do better:

Some recommendations were made at this inspection to improve and develop the service further. The manager acknowledges that care-planning documentation does not always support the level of care actually provided to residents. Care plans could be developed further to provide a more personalised care record for nurses and care staff to follow. Social histories need to be recorded and care assessments reviewed more frequently. The manager does undertake care assessments for each new resident but community care assessments from social workers or hospital assessments nurses should be obtained before a new admission arrives in the home. Formal quality assurance systems also need implementing.

CARE HOMES FOR OLDER PEOPLE Park Hills Nursing Home 199 Chamber Road Oldham Lancashire OL8 4DJ Lead Inspector Tracey Rasmussen Unannounced Inspection 31st January 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 Hills Nursing Home DS0000025447.V279944.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 Hills Nursing Home DS0000025447.V279944.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Park Hills Nursing Home Address 199 Chamber Road Oldham Lancashire OL8 4DJ 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) 0161 624 6671 0161 624 6671 Ms Barbara Rogers Mrs Barbara Rogers Care Home 17 Category(ies) of Physical disability (3), Physical disability over 65 registration, with number years of age (17), Terminally ill (17) of places Park Hills Nursing Home DS0000025447.V279944.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No more than 3 service users between the ages of 18 to 55 to be admitted to the establishment. One registered nurse to be on duty throughout 24 hours. Date of last inspection 21st July 2005 Brief Description of the Service: Park Hills Nursing Home provides 24 hour nursing care and accommodation for up to 17 service users over the age of 65 years. Three services users under the age of 65 years may also be accommodated. Mrs Barbara Rogers is the registered owner and manager of the home. The home is situated approximately one mile from Oldham town centre and is reasonably close to local amenities such as shops, pubs and local schools. Bus services are also available close by. The home is a Victorian property that has been extended at the rear. Entrance to the home is by a purpose built ramp at the side of the building. Well-maintained gardens are available outside the property. The home provides 17 single bedrooms, on both the ground and first floor and the majority of these are south facing. A passenger lift and other aids, such as hoists are available. There are three bathrooms. On the ground floor there is a choice of a large lounge/dining room or a smaller quiet lounge. Park Hills Nursing Home DS0000025447.V279944.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over four hours on the 31st January 2006 by one inspector. Many of the standards were not assessed at this inspection has these had been assessed at the previous inspection on the 21st July 2005. Similar comments made at the previous inspection have been repeated in this report as the quality and focus of the service has been maintained at a consistent standard. A tour of the home took place and care records were seen. All 17 residents were observed and several were spoken to. Two visitors and two staff members were spoken to. Verbal feedback of the findings from the inspection was given to the manager at the end of the visit. What the service does well: The home provides a specialist service in that it focuses on providing end of life care. This is provided in a peaceful relaxed and friendly home where resident dignity and comfort is a priority. It is emphasised by the manager and in the home’s information guides that social activities and entertainment are not provided as this is not appropriate to meet the resident’s needs living in the home. Residents spoken to said they liked living in the home and were complimentary about the staff. Many of the residents spoken to had been living in the home for a long time. All residents seen appeared peaceful and comfortable. Bedroom décor and soft furnishings coordinated and these were maintained clean, neat and tidy. The home has a committed stable staff group who are enthusiastic and motivated to do a good job. Staff confirmed training had been provided in the home and they felt they had received good training and support by working alongside nursing staff. The home encourages families and visitors to call in at any time and to discuss concerns. The manager continues with a programme of on-going refurbishment. Since the last inspection all bedrooms, hallways, stair and one lounge has been redecorated. The kitchen has been refurbished. Communal lounges provide Park Hills Nursing Home DS0000025447.V279944.R01.S.doc Version 5.1 Page 6 traditional homely areas with leather suites and grand dining table in keeping with the Victorian period of the home. 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. Park Hills Nursing Home DS0000025447.V279944.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 Hills Nursing Home DS0000025447.V279944.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): 3 and 4 Resident’s needs are assessed before they move into the home and the home can confirm they can meet the needs of the resident on admission. EVIDENCE: The manager explained that she assessed all potential new residents, before admission to the home to determine if the individual care needs of the new resident could be met by the home. Residents spoken to said they had come into the home because they had heard of the home’s reputation. A sample of care files were examined and all had some form of community care assessment or nursing assessment and these were supported by the home’s own assessment of the resident’s needs. The manager did state that on occasion community care assessments and or nursing assessments were not always obtained. Residents and one relative spoken too said they were ‘very happy’ and ‘very satisfied’ with the care they received. The home does not provide intermediate care. Park Hills Nursing Home DS0000025447.V279944.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 and 10 Residents are treated with respect and dignity. The care planning documentation was sufficient to meet personal and health care needs of residents. EVIDENCE: The hands-on nursing and care service provided in the home is of a high standard. The manager of the home also works providing hands-on care to residents and has daily contact with families. The home was peaceful and staff undertook their duties quietly and efficiently. Care practices observed promoted the comfort, privacy and dignity of the residents. Residents spoken too at this inspection and previous inspections confirmed that they were maintained comfortably and that the care needs were met appropriately. Feedback received directly at the Commission for Social Care Inspection (CSCI) in the last year has been positive and complimentary of the care service. One staff member stated that she felt ‘the care given in the home was of an high standard’ and ‘the manager expected these standards to be maintained at all times’. Park Hills Nursing Home DS0000025447.V279944.R01.S.doc Version 5.1 Page 10 Many of the residents living in the home were maintained comfortably in bed. Nightwear clothing and bedding looked fresh and clean. Bedrooms were pleasant, clean and tidy. Friends and relatives were welcomed at any time into the home. The manager has reviewed her care planning documentation since the last inspection and addressed the requirements made. Care plans detailed comprehensively the care needs of the residents living in the home and the actions did contain more information about how each resident’s needs were to be met. This could be further developed to provide a more person centred care plan. Care plan evaluations were good and provided information about the effectiveness and progress the resident was making. Assessment information was recorded but this does need reviewing more regularly than currently. The manager did state that the home was in the process of rolling out a programme of providing height adjustable beds in the home so ensuring physical care needs of residents could be met safely. Park Hills Nursing Home DS0000025447.V279944.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 and 15 Resident’s lifestyle choices and social needs are respected. The quality of food provided to residents is good offering choice and variety and catering for special dietary needs. EVIDENCE: Park Hills does not provide a service, which offers daily social activities to residents. The emphasis of the service is on care and comfort to people who are nearing the end of life. Staff did spend time with residents in providing care in a unhurried manner. Resident’s spent most of their time in their bedrooms and they confirmed that this was their choice. The manager did emphasise to potential new residents and their families that traditional activities were not provided in the home. Music according to the resident’s preference was played in the bedrooms and one resident did the daily crossword with staff. Care records detailing the social background of the residents could be developed further. A rolling menu for meals is available and alternatives are provided. At this visit a high number of residents required assistance with a pureed diet. Staff Park Hills Nursing Home DS0000025447.V279944.R01.S.doc Version 5.1 Page 12 provided assistance to each resident in a timely manner. Staff said they did not feel rushed at meal times and assistance was provided at pace appropriate to the resident’s needs. The kitchen had been refurbished and the cook was undertaking training provided by the local environmental health department. The cook stated that an environmental health officer had recently been to the home and no requirements or recommendations were made. Park Hills Nursing Home DS0000025447.V279944.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): Not assessed at this inspection EVIDENCE: Park Hills Nursing Home DS0000025447.V279944.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): Not assessed at this inspection EVIDENCE: Park Hills Nursing Home DS0000025447.V279944.R01.S.doc Version 5.1 Page 15 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 and 30 Staff are trained to meet resident’s needs and staffing levels are appropriate to ensure needs are met in a timely maner. EVIDENCE: The home’s rotas identified that staffing levels were maintained in the home at a consistent level to meet the needs of the residents. One staff team member said that there was good team work in the home and they all helped out if the home was short staffed. The manager of the home continues to maintain links with external nurse professionals to provide in-house training to both nurses and care staff. Training had recently been provided in mandatory health and safety and one care staff member listed the training she had undertaken. An NVQ assessor was in the home working with one care worker. To ensure this staff member was supported the manager had increased the home’s staffing levels for the day. Other staff spoken too either had an NVQ qualification or were working towards one. The manager had developed and implemented an induction-training programme but this focused primarily on corporate aspects of employment. The manager or senior staff provided induction training in care practices to new care workers by working alongside them. Records of this training were not always recorded in detail but care staff spoken to confirm that they had Park Hills Nursing Home DS0000025447.V279944.R01.S.doc Version 5.1 Page 16 worked frequently with the manager who showed them how to deliver care properly. Following the discussion the manager approached the NVQ assessor to request some information on induction recording in line with Skills for Care. Park Hills Nursing Home DS0000025447.V279944.R01.S.doc Version 5.1 Page 17 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 and 38 The management of the home promotes the health, safety and wellbeing of the residents. Resident and relatives do informally have a say, in how the home is run. EVIDENCE: The owner/manager of the home set the nursing home up in the 1980s and has always worked there. She has recently obtained a NVQ 4 in management. Discussion with the manager identified that she remains focused and committed to providing a specialised high quality service. The manager does employ an administrative manager to provide administrative support. Formal quality assurance systems have not been established in the home but the manager stated that she saw residents and relatives on a daily basis and any issues or concerns are dealt with there and then. Residents spoken too Park Hills Nursing Home DS0000025447.V279944.R01.S.doc Version 5.1 Page 18 said, they were happy with the service and ‘they had nothing to complain about’. The home does not any hold money for residents (Standard 35). Health and safety records were available. The fire officer was reported to have recently visited and was satisfied with the home. Routine maintenance was undertaken and general work place risk assessments had been and continued to be developed. Park Hills Nursing Home DS0000025447.V279944.R01.S.doc Version 5.1 Page 19 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 x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x x x x x x x x x STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 x N/A x x 3 Park Hills Nursing Home DS0000025447.V279944.R01.S.doc Version 5.1 Page 20 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. 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 Refer to Standard OP3 Good Practice Recommendations The registered person should ensure that community care assessments or nursing assessments are consistently obtained before the admission of new service users in the home. The registered person should ensure that care interventions are more specific to each individual service user. The registered person should ensure that service user assessments for nutrition and skin integrity are reviewed monthly. The registered person should ensure that a social history is available on the resident’s care files. The registered person should ensure that induction records in care practices are recorded in more detail. The registered person should ensure that formal quality assurance systems are implemented. 2 3 4 5 6 OP7 OP8 OP12 OP30 OP33 Park Hills Nursing Home DS0000025447.V279944.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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