Inspection on 10/11/05 for Park House

This inspection was carried out on 10th November 2005.

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 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 House 20/11/08

Park House 22/11/06

Park House 19/05/05

Park House 19/11/04

Park House 18/05/04

Park House 14/10/03

Park House 06/05/03

Park House 28/05/02

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

CARE HOMES FOR OLDER PEOPLE Park House James Street Tyldesley Wigan Greater Manchester M29 8JJ Lead Inspector Lindsey Withers Unannounced Inspection 10th November 2005 09:15 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 House DS0000005757.V264871.R01.S.doc Version 5.0 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 House DS0000005757.V264871.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Park House Address James Street Tyldesley Wigan Greater Manchester M29 8JJ 01942 882344 01942 886188 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) CLS Care Services Limited Mrs Sharon Davies Care Home 40 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (40), of places Physical disability over 65 years of age (8) Park House DS0000005757.V264871.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 40 service users to include, up to 40 service users in the category of Older People (OP) 8 service users with Physical Disabilities over 65 years of age PD(E) and 3 female service users in the category of Dementia over 65 years of age (DE(E)). The service should at all times employ a suitably qualified and experienced Manager who is regsitered with the Commission for Social Care Inspection. Three service users may be accommodated in the category of DE(E). The Homes Statement of Purpose must be altered to set out how the services and facilities offered by the Home will meet the needs of the three individual service users with dementia by 01.09.2004. The Home`s Manager and senior carers must be adequately trained to meet the specific needs of the three individual service users with dementia by 01.11.2004. The Home`s carers must be adequately trained to meet the specific needs of the three individual service users with Dementia by 01.02.2005. 19th May 2005 2. 3. 4. 5. 6. Date of last inspection Brief Description of the Service: Park House, part of the CLS group of homes, is situated close to Tyldesleys local amenities and is well served by public transport. The Home is a single storey building, which is set in well-maintained grounds. Park House is registered to provide personal care for 40 residents of either sex over the age of 65, 8 of whom may have a physical disability, and 3 of whom may have dementia. All bedrooms are offered as singles; there are no shared rooms at Park House. Park House DS0000005757.V264871.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over a 4.5 hour period and was unannounced. The main focus was on those areas not assessed during the previous inspection, so that over both visits all key standards were looked at. Matters raised at the last inspection were followed up on. Part of the time was spent with the Manager going through the paperwork that she needs to keep to show that the home is being run properly. Some time was spent with the Home Services Manager looking at residents’ finances. The Inspector had good conversations with four members of staff and six residents. Other staff and residents were spoken to over the course of the inspection. What the service does well: What has improved since the last inspection? Covers have now been fitted to all radiators, making the building more safe for residents to move about it. CLS is introducing a new policy and procedure in relation to the Protection of Vulnerable Adults (PoVA). Training for staff is scheduled to take place over the coming months. Following the training, staff will be better informed about the protection of old and vulnerable people and about the new system for speaking out about poor practice. The activities programme, which includes activities and events inside the home and trips out to places of interest, continues to improve. Research is being done so that all residents – regardless of physical or mental ability – can enjoy some social time. This area of care, according to residents, is “much better”. Park House DS0000005757.V264871.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Park House DS0000005757.V264871.R01.S.doc Version 5.0 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 House DS0000005757.V264871.R01.S.doc Version 5.0 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 Pre-admission assessments are good. Residents can be assured that when they move into Park House their assessed needs can be met. EVIDENCE: A selection of care plans was looked at, including two for recently-admitted residents. The information contained in the files showed that a full assessment had been done prior to the person coming to live at Park House, taking into account the person’s health and social care needs, expectations and preferences. It was evident from the documentation that the resident – and/or their supporter – had been involved in the assessment process. Park House DS0000005757.V264871.R01.S.doc Version 5.0 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 and 8 The poor standard of recording in care plans is unacceptable and does not reflect the good standard care that residents themselves say they receive. Files cannot demonstrate that a person’s changing health, personal and social care needs have been identified and can be met by the home. Neither can files confirm that the health and well-being of residents is promoted and maintained. EVIDENCE: The quality of the content of care plans had been the subject of a requirement at the last inspection. In the sample of care plans looked at during this inspection, improvements were not sufficient to show that the changing needs and expectations of residents are identified, monitored, and reviewed in a thorough and measurable way. This lead to an immediate requirement being served by the Inspector, and a monitoring visit scheduled for 14th December 2005 on the understanding that the documentation will be up to standard at this visit. There were errors and omissions on all of the six files that were looked at, some more significant than others, but all impacting on the quality of care being provided. Park House DS0000005757.V264871.R01.S.doc Version 5.0 Page 10 Some of the files that were looked at had been audited by the Manager. In some cases, she had identified where improvements needed to be made. However, the improvements had not been made and this reflects badly on the members of staff responsible for the individual files as – on paper at least – it looks as if they have disregarded the Manager’s comments. More frequent audits should reduce some of this inaction. The findings made during this inspection were discussed fully with the Manager of the home. It was the Manager’s view that the level of care being delivered is not being reflected in the care plan and, speaking with staff, it was clear that they shared a common goal of providing good care. Residents were complimentary about the care provided to them, and spoke well about the staff, making comments such as “nothing is too much trouble”, “staff see to everything for you”, and that staff were “very good”. Park House DS0000005757.V264871.R01.S.doc Version 5.0 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, and 15 Residents coming to live at Park House can be sure they will be helped to live as full and independent a life as they would wish. Residents are be able to express opinions and make choices about how they live their lives. The food that is offered is good and plentiful, with sufficient variety and choice. Residents are free to have visitors and will be encouraged to maintain the links they had before they moved into the home. EVIDENCE: Since the last inspection, there had been a change in the occupancy at the home and some of the more active people were no longer living there. As a result, the Activities Organiser was having to adapt and change the social programme to suit. Residents were complimentary about the variety and frequency of activities and social events, and it was clear that they were doing things that they wanted to do. Residents said they could join in if they wanted to, but were also free to spend time as they wished, for example, one resident said watching television was “good enough” for her, while another enjoyed going out to the shops every day. Efforts are being made to cater for those residents with hearing or visual impairments, as well as those with physical disabilities. The garden is well-maintained. Bird-feeders and nesting boxes have been put out so the garden is home to a host of wild birds which the residents enjoy watching. Park House DS0000005757.V264871.R01.S.doc Version 5.0 Page 12 A number of residents said they had regular visitors including grandchildren and great-grandchildren. Visitors can join residents in their own room or in one of the lounges. In conversations with residents, they showed they were not only well-informed about what was going on in “the outside world” (as it was described), but also about what was going on inside Park House. Residents displayed independence of mind – and were not prevented from doing so. While some residents were frustrated by the restrictions that their individual physical condition placed upon them, they said they had all the help they needed to live an independent a life as possible. Good examples of choice were observed and discussed relating to all manner of daily activities from rising and retiring times, to bathing, food, and leisure and social activities. The care plans showed that where specific choices had been expressed by residents, these had been recorded. Only one adverse comment was received in relation to meals. This person said that the food was not what had been eaten at home. However, the person understood that the home was catering for a large number of people with varying dietary requirements. Although food could be a bit “hit and miss”, there was sufficient quantity. All other residents who expressed a view about food said it was very good, suited their taste, and that there was plenty, so they could have extra if they needed or wanted it. Residents were given assistance by staff to eat their meals if they needed it, and specially adapted crockery and cutlery was available to help people eat independently. Park House DS0000005757.V264871.R01.S.doc Version 5.0 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): 18 Residents living at Park House can be sure they will be protected from abuse in any form. EVIDENCE: A new policy and procedure had been issued by CLS in August 2005 in relation to the Protection of Vulnerable People (PoVA). The Manager had received the video and training pack and training workshops for all staff had been scheduled through November, December, and January. Though staff at Park House are committed to the people they care for, this training will ensure they are reminded about their obligations to safeguard residents from harm. One of the residents told the Inspector about the National Vocational Qualification (NVQ) training that members of staff were undertaking. She said this was good for residents: staff were properly trained so there was “less chance of abuse”. The Manager had also received a copy of the most recent PoVA joint procedures for Wigan which she was in the process of reading. Staff are not employed at Park House unless they have been properly screened by the Criminal Records Bureau and satisfactory references have been received. Park House DS0000005757.V264871.R01.S.doc Version 5.0 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 and 26 The layout of the building includes ample communal space for residents. Consideration may need to be given to how it is used so that residents’ collective and individual needs are met. Domestic staff are properly trained and are employed in sufficient numbers so that the home is kept clean. EVIDENCE: At the last inspection, it had been identified that communal space was not organised well enough to meet the social needs of the residents. Now that the resident group had changed, this was no longer an issue and the requirement is no longer relevant. However, the Manager should continue to bear in mind that residents may wish to have activities in places other than the lounge or dining room. The redecoration programme was continuing. Radiator covers have now been fitted throughout. Park House DS0000005757.V264871.R01.S.doc Version 5.0 Page 15 In conversations, domestic staff displayed a good level of understanding about controlling the spread of infection in order to maintain a high standard of hygiene in the home. Staff were familiar with the policies and procedures that they had to follow, and had been trained so that they could use equipment properly and products safely. Park House DS0000005757.V264871.R01.S.doc Version 5.0 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): 29 Residents can be sure that they will be cared for only by people who are properly recruited and who are suitable to work with older people. EVIDENCE: The staff team at Park House is a very stable group and many are long serving. There has been no recruitment since the last inspection. However, the process that might be followed was discussed with the Manager, and she was able to demonstrate that her knowledge of the process was satisfactory. The Manager spoke about the need to take up references and to make checks with the Protection of Vulnerable Adults register and Criminal Records Bureau. New recruits would not work unsupervised until they had undertaken a full, nationally recognised induction programme, and an induction to the home. New recruits also worked with a “buddy” during their initial employment period. Park House DS0000005757.V264871.R01.S.doc Version 5.0 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): 33 and 35 The care plan audit is not as effective as it could be, which impacts on the care provided to residents. The home has systems in place that are properly managed so that residents’ financial interests are safeguarded. EVIDENCE: The auditing of care plans had been identified as an area for improvement at the last inspection. On this occasion, it was evident that a care plan audit had taken place. However, staff had not followed up on the Manager’s comments and, hence, changes had not been made. The auditing of care plans needs to be better if improvements are to be made and sustained. The records showed that money is kept by the home on behalf of the majority of residents, though a small number maintain control over their own finances with the help of their families or social worker. Money (known as cash control) is kept to pay for hairdressing, newspapers, bingo, trips, additional toiletries, etc. Park House DS0000005757.V264871.R01.S.doc Version 5.0 Page 18 The cash control for four residents was checked. The records showed money coming in and going out of the resident’s cash control. With the exception of one which had a minor discrepancy, those individual funds checked during this inspection were found to be correct and up to date. Park House DS0000005757.V264871.R01.S.doc Version 5.0 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 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 2 x 3 x x x Park House DS0000005757.V264871.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard OP7 OP8 Regulation 15 13 Requirement Care plans must be up to date and reviewed at least monthly. Immediate requirement issued. Risk assessments must be in place for all residents, and must be reviewed at least monthly. Timescale 15/7/05 not met. The auditing system for care plans must be carried out more frequently. Timescale for action 14/12/05 14/12/05 3. OP33 24 31/12/05 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 OP19 Good Practice Recommendations The Manager should continue to keep in mind that communal space may need to be re-arranged as residents’ needs change, for example, for activities. Park House DS0000005757.V264871.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 House DS0000005757.V264871.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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