Inspection on 11/01/06 for Park House

This inspection was carried out on 11th 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.

Other inspections for this house

Park House 17/10/07

Park House 28/02/07

Park House 08/09/05

Park House 15/02/05

Park House 16/08/04

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

CARE HOMES FOR OLDER PEOPLE Park House 1 Walton Park Bexhill-on-sea East Sussex TN39 3NH Lead Inspector Andy Denness Unannounced Inspection 11th January 2006 14:15 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 DS0000021183.V277567.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 House DS0000021183.V277567.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Park House Address 1 Walton Park Bexhill-on-sea East Sussex TN39 3NH 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) 01424 211258 phil@brit45.freeserve.co.uk Mrs Jacqueline Brittain Vacant Care Home 7 Category(ies) of Dementia (7) registration, with number of places Park House DS0000021183.V277567.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum service users to be accommodated is 7. Service users should be aged 65 years or over on admission and have a dementia type illness. 8th September 2005 Date of last inspection Brief Description of the Service: Park House is a detached property situated approximately one mile from Bexhill town centre. Accommodation is on two floors with a stair lift fitted to assist service users access first floor accommodation. The home has a large garden, which is shared with a next door care home next door that is owned by the same proprietor. The home is registered to accommodate up to seven older people who have a dementia type illness, the registered owner is Mrs J Brittain. Park House DS0000021183.V277567.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 an afternoon in January and lasted three hours. To help gather evidence on how the home is performing the Inspector met with staff and the manager and examined a range of records and written information. An inspection of the premises took place. Discussions took place with all seven service users currently resident and with two visitors who were visiting a relative at the time of the inspection. What the service does well: What has improved since the last inspection? What they could do better: It has been required that the manager checks with the fire brigade to ascertain if the current arrangements for stopping service users from accessing the stairs unaccompanied are safe from a fire prevention view point. To ensure that the Commission for Social Care Inspection are aware of all dangerous happenings, it has been required that the manager ensures that she informs the Commission of all significant occurrences. It has been required that at least 50 of staff are trained to the required national level, this will ensure that staff have the knowledge and skills to meet service users needs. It has been recommended that the current office and telephone arrangements are reviewed to make sure that staff can effectively communicate by telephone and so that the confidentiality of information regarding service users is protected. Park House DS0000021183.V277567.R01.S.doc Version 5.1 Page 6 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 DS0000021183.V277567.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 House DS0000021183.V277567.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): 1,3 & 6. Pre admission procedures are satisfactory and help ensure that service users are admitted to a home that is suitable to meet their assessed needs. EVIDENCE: A statement of purpose is in place for the home, this document provides guidance for prospective service users and their relatives about the home and the service provided, it has been recommended this is amended to reflect a description of the environment and service actually provided at Park House rather than just a general statement relating to all homes owned by the proprietor, as is currently the case. The assessment of need of the only service user to move into Park House since the last inspection was examined, it contained all required information and was of a satisfactory quality. An assessment undertaken by the Social Worker who had arranged the placement was also in place. The home does not provide an intermediate or rehabilitation service. Park House DS0000021183.V277567.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 9. The policies, procedures and practices in the home regarding meeting the health, personal and mental health needs of service users are satisfactory and help ensure that identified needs in these areas are appropriately met by staff. EVIDENCE: Using the initial assessment of need as a starting point individual plans of care are compiled for each service user; these identify amongst other things what support they need from staff to meet their day to day needs in relation to health, personal and mental health needs. The plans for two service users were examined; they were of a satisfactory quality and provided sufficient guidance for staff. From observations made, discussions with staff and service users and records examined it was evident that needs identified in the plans were being appropriately met by staff. Because of their mental health needs, service users do not manage their own medication, this is done for them by staff; a system that is easy to monitor is used, storage and records were examined and found to be in order. Park House DS0000021183.V277567.R01.S.doc Version 5.1 Page 10 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): 15 Arrangements regarding meals are good ensuring variety and choice for service users. EVIDENCE: Menus that were examined indicated that a wholesome and varied menu is provided. Service users were complimentary of the meals provided for them, their comments included, “the food is excellent” and “the food is good”. Records examined confirmed that specialist diets are provided when required. Park House DS0000021183.V277567.R01.S.doc Version 5.1 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18. Arrangements regarding complaints and adult protection matters are satisfactory and service users’ rights to be registered to vote are upheld. EVIDENCE: The home has detailed complaints procedure in place, this document was examined it was of a satisfactory standard. Records examined confirmed that the manager investigates complaints in line with the written procedures. The Inspector was told that since the last inspection most staff have been trained in adult protection matters. The manager showed the Inspector a copy of the Local Guidelines regarding what action should be taken if abuse is suspected. She also said that she has recently arranged for all service users to be registered to vote. Park House DS0000021183.V277567.R01.S.doc Version 5.1 Page 12 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): 19,20,21,22,23,24,25 & 26. Physical standards and accommodation throughout the home are good and ensure that service users live in a comfortable, well maintained and generally safe environment although a requirement has been made regarding the current office arrangements and fire safety. EVIDENCE: An inspection of all areas of the environment confirmed that physical standards throughout the home are good. Bedroom accommodation is provided in five single and one double rooms, all of which comply with the size requirements of national minimum standards; the Inspector was told that service users are able to bring their own furniture with them if they so wish, some have done this, which has resulted in pleasant personalised rooms. Communal accommodation includes a lounge, dining room and a small sun lounge; these rooms are furnished and decorated in a comfortable homely style. However part of the dining room is also used as an office; this means that sometimes confidential records are not stored securely and that confidential conversations regarding service users can be overheard, action has been required to address Park House DS0000021183.V277567.R01.S.doc Version 5.1 Page 13 these problems. Gates are positioned at key areas in the home to ensure service users do not harm themselves in potentially dangerous areas; this includes at the top and bottom of the stairs, both of which are now locked. Because of potential dangers of this in the event of a fire the manager has been required to liaise with the local Fire Brigade to ascertain if this practice can continue. Heating is provided by a gas central heating system with radiators in all rooms, which are all guarded. Tests confirmed that hot water is delivered to wash hand basins and baths at a safe temperature. The home is fitted with a stair lift to assist service users access first floor accommodation. The main bathroom is fitted with a special bath seat to assist access and handrails and other adaptations are fitted in key areas to assist those with mobility problems. A satisfactory standard of cleanliness was found in all areas of the home. Written policies are in place regarding infection control and training plans examined confirmed that staff are trained in the subject. The home has large gardens laid to lawn and flower beds. Park House DS0000021183.V277567.R01.S.doc Version 5.1 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 & 29. Staff arrangements are generally satisfactory ensuring that service users needs are met by sufficient numbers of trained staff. EVIDENCE: Records examined confirmed that staffing levels consist of two care staff on duty at all times during the day and one member of waking night staff. Care staff also undertake all cleaning and catering duties. These levels are generally satisfactory however it was noted that one service user who requires two staff to get them ready for bed goes to bed early as there is only one member of staff is on duty after 7pm; following a requirement made at the last inspection arrangements have been made for additional staff to be accessed if the service user wishes to stay up late, this is not an ideal situation and the matter should be constantly monitored to ensure that staffing arrangements take into account service users wishes and lifestyle. Staff were observed to work in a caring and respectful way with service users; comments from service users and relatives regarding staff included “staff are lovely”, “staff help me” and “staff, there are plenty”. Records examined confirmed that staff are trained in food hygiene, moving and handling, fire prevention and first aid. Currently 50 of staff are not trained to NVQ level as is required, however the manager said that several staff have started their training. The owners of the home hold recruitment records centrally; a recent inspection of them confirmed that satisfactory recruitment procedures are followed when new staff are employed. Park House DS0000021183.V277567.R01.S.doc Version 5.1 Page 15 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, 33, 35, 37 & 38 Management and administrative systems in the home are good and work well in supporting staff in their day-to-day work. EVIDENCE: The manager is relatively new in post and is has applied to the Commission for Social Care Inspection to be registered, this process is nearing completion; she said that she has started one of the management training courses required by national minimum standards, and hopes to finish it in the near future. She is experienced in caring for older people with dementia and throughout the inspection demonstrated a clear understanding of the needs associated with their condition. Since the last inspection the manager has introduced a quality assurance system, which involves consultations with each service user to ascertain their views of the service that they receive, records examined confirmed that this process has been completed. The manager said that the home does not hold any money on behalf of service users. A selection of Park House DS0000021183.V277567.R01.S.doc Version 5.1 Page 16 records and policies and procedures required by regulation were examined, these were in order, however as mentioned earlier in this report current office arrangements mean that records are not all stored securely. It was also noted that current arrangements for the office telephone consist of a pay phone; this could hamper communications and it has been recommended that this situation be reviewed. The manager showed an understanding of health and safety matters including the risk assessment process. A selection of health and safety records were examined, these were in order. Park House DS0000021183.V277567.R01.S.doc Version 5.1 Page 17 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 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 2 2 Park House DS0000021183.V277567.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP28 OP37 Regulation 18(1)(a) 37 Requirement Timescale for action 11/07/06 3 OP19OP38 23(4)(a) That at least 50 of staff are trained to the required national level. (NVQ level 2) That the manager ensures that 11/01/06 she informs the Commission for Social Care Inspection of all significant occurrences that affect the wellbeing of service users. That the fire brigade are 11/02/06 consulted to ascertain if the current arrangements for limiting access to first floor accommodation are safe. 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 OP1 OP19OP37 Good Practice Recommendations That the home’s statement of purpose is individualised to the home. That the current arrangements regarding the office and telephone calls are reviewed to ensure effective DS0000021183.V277567.R01.S.doc Version 5.1 Page 19 Park House communication and confidentiality. Park House DS0000021183.V277567.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 DS0000021183.V277567.R01.S.doc Version 5.1 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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