Inspection on 20/11/08 for Park House

This inspection was carried out on 20th November 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Park House 22/11/06

Park House 10/11/05

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 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Park House James Street Tyldesley Wigan Greater Manchester M29 8JJ     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lucy Burgess     Date: 0 3 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Park House James Street Tyldesley Wigan Greater Manchester M29 8JJ 01942882344 01942886188 sharon.davies@clsgroup.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Sharon Davies Type of registration: Number of places registered: CLS Care Services Limited care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The home is registered for a maximum of 40 service users to include:- up to 30 service users in the category of OP (Older People over the age of 65). up to 8 service users in the category of PD(E) (Older People over 65 years with a physical disability). up to 10 service users in the category of DE(E) (Older People over 65 years with dementia) The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. The service should employ suitably qualified and experienced members of staff, in sufficient numbers, to meet the assessed needs of the service users, including those with dementia. Date of last inspection Care Homes for Older People Page 4 of 29 Over 65 10 40 8 0 0 0 Brief description of the care home Park House, part of the CLS group of homes, is situated close to Tyldesleys local amenities and is well served by public transport. Park House is registered to provide personal care for up to 40 residents of either sex over the age of 65, 10 of whom may have dementia. The Home is a single storey building, which is set in well-maintained grounds. All bedrooms are offered as singles; there are no shared rooms at Park House. At the time of this inspection weekly fees ranged from 420.00 to 505.00 pounds per week. Additional charges were for hairdressing, outings, newspapers, toiletries etc. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The service was last inspected by us on the 22 November 2006. This was a key inspection, which included a site visit and took place over two days for a period of 9 hours. The service did not know that the inspector was going to visit. The first day was spent looking at records and speaking with the acting manager. The second visit involved looking round the home, speaking with people and staff as well as examining the medication system. As part of the inspection process the providers are asked to complete a selfassessment survey information document (Annual Quality Assurance Assessment). This Care Homes for Older People Page 6 of 29 was sent to the home before the inspection and had been completed by the registered manager and returned to us prior to the site visit. Other information was gathered from the feedback surveys we sent out. We received completed surveys from 7 people living at the home and 7 staff members. Comments have been added to the report. Discussion and feedback was held with the acting manager during the visit. What the care home does well: What has improved since the last inspection? What they could do better: Information gathered as part of the assessment process needs to be expanded on to evidence the level of support required ensuring people are only placed at the home if their full needs can be met. The administration and recording of medication must be improved ensuring a safer system is in place and people are not placed at risk of harm. Care plans and risk assessments should be reviewed and updated on a monthly basis or more frequently ensuring information reflects the current and changing needs of people. A plan of work should be developed identifying redecoration and refurbishment required within the home along with timescales for completion. A copy should be forwarded to CSCI. More detailed records need to be maintained with regards to health and safety checks carried out within the home to ensure the environment is safe and people are not placed at risk. Staffing levels should be kept under review making sure that there are sufficient staff on duty at all times to meet the needs of people living at the home. Care Homes for Older People Page 8 of 29 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed information about the assessed needs of prospective new residents needs to be gathered prior to admission to ensure that the persons needs can be met at the home. Evidence: The admissions information was looked at for someone who had very recently moved into the home. We were told by the acting manager that the assessment carried out by the placing authority had not yet been received. However a copy of the homes assessment was on file. This person had recently been referred back to the local authority and to the specialist nurse as the home felt that the current placement was not meeting their full needs and the person would be better placed on the Manor Park unit. The assessment form looked at all areas in relation to the persons social, emotional and physical health. Care Homes for Older People Page 11 of 29 Evidence: No issues were identified at the point of assessment. The acting manager stated that the level of need had not been made fully apparent prior to the placement being made. On examination of the assessment document we noted that statements are made in each area. The most relevant statement is then highlighted by the assessor to identify the person needs. However information had not been expanded upon. For example some statements are; I am at risk of falling or I am anxious sometimes. There was no information added to expand on what this meant and the level of support required. Without such information it is unclear how the home is able to determine that the placement is suitable. The acting manager advised us that new documentation was to be introduced called My Life Plan. This is written in the first person and is to promote a more person centered plan. The document includes an assessment, admission checklist, care plan, medication as well as other health care monitoring information. It was noted that space is provided on the assessment form for comments to be made including the current support I need and any specialist assessments or input. It is essential that these areas are completed so that only those people whose needs can be met are placed at the home. Standard 6 does not apply as the home does not provided intermediate care services. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information about the current and changing needs of people should be kept up to date so that people are supported in a way, which meets their needs. A safer medication system must be provided so that people are not placed at risk of harm. Evidence: A sample of care files were looked. Information was in place with regards to how people were to be supported by staff. Information had been recorded in the first person and looked at areas such as mental health, communication, diet, personal care, mobility, routines, and religious needs including death. Only one of the plans had been signed by the person to evidence their involvement. Other information included risk assessments, which covered a number of areas including pressure care, nutritional needs, moving and handling and smoking. Action was identified providing direction for staff ensuring peoples health and well-being was maintained. Care Homes for Older People Page 13 of 29 Evidence: For one person their waterlow assessment had not been updated since the 16 October 2008. This had been given a very high risk score although the information was incomplete, as their weight had not been recorded. This persons care needs had recently changed resulting in them spending more and more time in bed due to their poor and failing health. Due to this the assessment must be kept under review so that any risk is minimised and the persons health is maintained. Each of the files examined had not been reviewed for some time. Where there had been changes in specific areas this had been updated however had not been continued throughout the plan. Risk assessments also needed to be updated to reflect the recent changes in peoples health ensuring that the level of intervention required was being provided. On one file the plan stated that the persons fluid and food intake needed to be monitored due to changes in their diet however this had not been reflected in the risk assessment. Without up to date information about the current and changing needs of people there is no assurance that people needs will be safely met. Some information was not easy to track, for example weight records. Whilst they appeared to have been carried out on a weekly basis information had initially been recorded on the weight record form then at times detailed on the personal care chart. So that the health care needs of people can be easily audited it is advised that the use of some of the records are revised so that staff are clear where information needs to recorded. People clearly have access to all health and social care professionals ensuring their continued and changing needs are fully supported. There was evidence on one file that support and guidance had been provided from the persons GP, specialist (Macmillan) nurse and palliative nurse so that support could be provided for this person in the best possible way. Another person had also been identified as having changes in their mental health. Contact had been made with their social worker and the advance practitioner to further review this persons needs and explore the level of support required. Two people commented in the surveys, I am very satisfied with the care at Park House and the staff help me night and day. Time was spent looking at the way medication is managed. At present there are two systems being used within the home. Those people residing on the Manor Park unit have their own medication and records held in their own bedrooms, with lockable storage secured to the wall. On the other unit medication is held by staff in their office. Care Homes for Older People Page 14 of 29 Evidence: Prior to our visit we had been informed in line with regulation 37 that there had been several medication errors. On examination of the system during this visit we also found several errors, which potentially left people at risk. During a random check on Manor Park we found that one person had not been given medication the day prior to our visit and that morning. This was said to have been an oversight by the staff member. On examination of stocks and records on the other unit we found that records did not evidence people had been given all their medication as prescribed. For example one person had been administered 7am medication which was held in the blister packs however had not been given additional medication, which was held separately. A number of other records showed gaps in administration. This is concerning as some of the medication errors have been in relation to people being given medication, which had already been administered however had not been signed for. This is not safe practice and potentially leaves people at risk of harm. We also found the the administration records (MARs) where poorly managed. Some records had come lose from the folder and could easily be lost. Others appeared to be old documentation which could be archived so that only current medication is listed. A number of MARs also had handwritten notes and changes, which made some information difficult to follow. Examination of items held in the fridge and controlled drugs was found to be safe. A controlled drug register is also held and found to be in order. Due to the issues identified the acting manager was advised by the inspector that a referral would be made for the pharmacy inspector to visit the home and carry out an inspection of the system. The acting manager told us that further medication training had been arranged for the week following the inspection for all staff responsible for the administration of medication. The providers must satisfy themselves that whilst staff have received training that they also have the competences needed when taking responsibility for administering peoples medication so they are not placed at risk. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. More opportunities for social interaction and stimulation are now being offered providing people with variety to each day. Suitable arrangements are in place with regards to meeting the dietary needs of people. Evidence: A number of surveys were received from people living at the home. One of the questions answered was in relation the choice of activities offered. Several people commented that sometimes or never were they provided. The acting manager explained that this had previously been an issue at the home as they have been without an activity worker for sometime. However a new activities coordinator has recently been appointed. Their hours are currently split between two CLS services however from January they will provide support only to Park House. We spoke with the new activities co-ordinator. They had only been in post for approximately 8 weeks however during that time had made an number of improvements with planned activities, outings and events being offered. People have recently enjoyed a trip to Blackpool to the illuminations, there has been a halloween Care Homes for Older People Page 16 of 29 Evidence: party, which included people making toffee apples, a visit from Barn Owl Bill who brought some birds into the home, several people had been involved in gardening, planting bulbs for the spring, as well as arts and craft, bingo and indoor bowls. Plans were also being made for the Christmas period. A family and residents Christmas Party had been arranged for the following week. Several people were also going to a Christmas party planned at the local social club and the Brownies and Dolphins were to visit providing a Christmas Carol Concert. The activities co-ordinator has set up the Park House Blog, which provides people at the home and visitors with information about what has taken place and future events. Photographs have also been added. A computer is available and a web cam is to be installed so that people are able to communicate with family and friends who may not live near to the home. There are also plans in the new year to develop a 4 weekly programme of activities, which people can choose from as well as exploring fund raising events. Speaking with the activities co-ordinator and acting manager it is clear they have a number of plans to develop this area further offering people a variety of activities both in and away from the home. We also looked at arrangements with regards to meals. There is a large dining room on the residential unit and a kitchen dining room on Manor Park. Tables were nicely set with tablecloths, cruets and flowers. All meals are prepared in the main kitchen however people living on Manor Park are able to prepare their own breakfasts as well as preparing potatoes and vegetables for their main meal. The main kitchen was found to be clean and orderly with several storage areas for fresh, frozen, dried and tinned goods. Food deliveries are made on a daily or weekly basis ensuring food stocks are well managed and rotated. There is a 5 weekly rota in place with the main meal being served in the evening. Alternatives are offered to those who would prefer something other than that on the menu. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place so that people feel listened to ensuring their safety and protection. Evidence: Policies and procedures are held at the home with regards to complaints and protection. People living at the home each have a copy of the complaints procedure, which can be found in the Welcome Pack in their rooms. Over the last 12 months 5 issues have been raised directly with the home. Records are held along with action taken to address matters. No concerns have been raised directly with us. With regards to safeguarding the home accesses training which is provided by the local authority. Further in-house training is also provided ensuring staff are aware of their responsibilities should someone disclose something to them. Up to date checks are carried out on all staff recruited ensuring they are fit to work at the home so that people are protected. Five of the seven people who completed our surveys said that they knew how to make a complaint. Two people were unsure. One person also commented, Ive never needed to make a complaint. Care Homes for Older People Page 18 of 29 Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Redecoration and refurbishment is needed throughout to enhance the appearance of the home providing people with a comfortable well maintained environment in which to live. Evidence: Park House is a purpose built home in the centre of Tydlesley. The home is close to all local amenities such as shops, public transport and GP surgeries. The home is all on ground level and accommodates up to 40 people who require support with their personal care needs. Ten people reside in the Manor Park unit, which supports people with specific dementia care needs. Manor Park comprises of an open plan lounge, dining kitchen room with direct access to a large secure garden and patio area, which has a small vegetable garden. Ash Walk and Beech Walk also has a large dining/lounge area, with several other lounge and sitting areas providing people with space to relax and socialize with each other. There is a further garden area, which people are able to access. In one part of the garden a shelter has been erected, which is the designated smoking area for people living at the home. Care Homes for Older People Page 20 of 29 Evidence: All bedrooms are single, none of which have en-suite facilities. A number of rooms were looked at. People had brought some personal items from home such as ornaments and pictures, which had been used to personalise their room. One person commented in the surveys, bedrooms are in need of refurbishment, decoration, curtains and bedding. The acting manager was aware of improvements needed within the home and was making arrangements to address these. There are a sufficient number of toilets and bathrooms throughout the home, which have been adapted to enable people to be supported safely. In one part of the building there is a further lounge and kitchen area, which is unused. The acting manager explained that they were looking at utilising this space for activities. Time was spent looking round the home. Some areas looked tired and in need of some attention. Ceilings are low and lighting quite dim, therefore appearing quite dark. Items of bedroom furniture were also broken. A plan of redecoration and refurbishment is needed along with timescales for completion to enhance the appearance of the home ensuring it is well maintained. CLS are currently developing new projects called Belong. One of the new developments is to be opened in Atherton in 2010 and will replace Park House and another home within the group. Facilities will include spacious living accommodation, en-suite bedrooms, shops, salon and restaurant. Those people living at Park House will move into the new home. The home employs a domestic supervisor and 9 domestic staff who take responsibility for cleaning the home including assisting in the kitchen or carrying out the laundry. The home was clean, tidy and free of odour. Suitable arrangements are in place with regards to the management of cross infection. Staff were seen to be wearing protective clothing when providing support with specific care tasks. Adequate hand washing facilities are provided throughout the home, however paper towels were needed in the laundry. People living at the home ticked always or usually when asked in the surveys if the home was fresh and clean. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are safely recruited and trained ensuring they have the knowedlge and skills required to support people safely. Evidence: The team comprises of the acting manager, home services manager, senior care team leader, 10 care team leaders and 5 senior care staff and 14 care staff. There are also 2 cooks, a maintenance/domestic worker, domestic supervisor and 6 domestic assistants. Care staff are designated to work on either Manor Park or Ash and Beech Walk. Staffing rotas were looked at to see what level of support is provided. Staffing on Manor Park comprises of a care team leader or senior and 1 carer with cover on Ash Walk and Beech Walk being 1 care team leader/senior and 2 carers. There are also 3 wake in night staff. Shifts for the care team leader overlap to allow for a hand over period at each shift change. Whilst looking round the home comments were heard from people enquiring where staff were as they had been calling for them but with no response. The home must keep staffing levels under review ensuring sufficient staff are on duty at all times so that the needs of people can be met in a timely manner. There are currently 2 vacancies at the home. The acting manager explained that staff Care Homes for Older People Page 22 of 29 Evidence: recruitment was taking place. This was to cover existing vacancies and reduce the use of agency staff. Staff files were looked for three staff employed this year. Information included, an application form with full employment history, 2 written references, copies of identification, health screening, contract and interview information. Staff had also signed to acknowledge that they had received a copy of the homes handbook and the GSCC code of practice booklet. A separate file is held with details of all criminal Record checks carried out on all staff working at the home. With regards to training over the last 12 months staff have been offered courses in mental capacity, moving and handling, medication, fire safety, infection control, nutrition, POVA and food hygiene. Further medication training is planned for the week following the inspection for 14 staff. Those staff designated to work on the dementia unit have completed dementia training. Copies of individual training records were provided and evidence that staff had received up to date training ensuring they have the necessary skills to carry out their duties. Induction training is now managed centrally and includes staff completing all mandatory training as well as basic dementia training. A more service specific induction is then carried out within the home so that staff are aware of the procedures to follow. Further training is provided with regards to NVQs. Of the 32 care staff, 18 have achieved the award at either level 2 or 3 whilst a further 6 staff are currently working towards the award. Of the ancillary staff, 8 have achieved an NVQ at either level 1 or 2 specific to their role. Seven staff completed and returned our surveys. Positive comments were made about the team and the training and support offered. Comments included, they offer regular training, supports new members of staff, up to date staff training, regular meetings to keep us up to date, I feel the service users get the individual care they need and staff are very approachable to them and their families, training for staff is very good and staff are well informed of training opportunities on offer and staff ensure clients are given independence and that all their needs are met. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appropriate management arrangements are in place ensuring people receive a service which meets their needs. Improvements should be made to health and safety records so that on-going checks are carried out ensuring the home is safe and people are not placed at risk. Evidence: At present the registered manager is not at work. Alternative management arrangements have been made to cover the home. A new home services manager has recently been appointed and a senior care team leader has been provided to offer the home and staff team some additional support. Systems are in place for reviewing the quality of service. The acting manager has spent some time reviewing systems in place at the home and has identified areas of development. There is a suggestion box within the reception area which enables people to make comments about the service. Other opportunities are available to seek Care Homes for Older People Page 24 of 29 Evidence: feedback from people including staff meetings being held and supervisions. Audits are also carried out covering health and safety, training, the environment, care plans and complaints. An evaluation of the service is carried out by an external company (RDB) who, again this year awarded Park House with 5 Stars. Regulation 26 monthly visits are also carried out by the organisation. Visits are carried out by a senior manager and the results of which are written into a report. This shows that CLS is monitoring the quality of the service being delivered at Park House and identifies where improvements need to be made, to make the service better for the people who live there. The system for managing peoples finances was also looked at. The home does not act as appointee for anyone. Responsibility is either maintained by the individuals themselves, a relative or appropriate representative. Personal allowances are held within the office and are used to pay for items such as trips, hairdressing, newspapers etc. Records and receipts are held to show that money is being managed properly. Periodic checks are carried out to ensure that money held balances with records. Records were looked at in relation to health and safety. Up to date servicing certificates were in place for the gas appliances, small appliances, electric circuits, fire alarm, nurse call system, emergency lighting and fire equipment. Safety checks are also carried out by the homes handy man however some of the records need to be improved to show all checks carried out. The acting manager was already aware of this and making arrangements to address this. The home keeps us informed of any accidents or incidents which may have occurred in line with regulation 37. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Care plans and risk assessments should be reviewed and updated on a monthly basis or more frequently if needed ensuring information reflects the current and changing needs of people. 30/01/2009 2 9 13 All medication must be administered as stated on the prescription ensuring the health and well being of people is not affected. 19/12/2008 3 9 13 Accurate records must be maintained with regards to the administration of medication so that errors do not occur and people are not placed at risk of harm. 19/12/2008 4 19 23 A plan of work should be developed identifying redecoration and refurbishment required 30/01/2009 Care Homes for Older People Page 27 of 29 within the home along with timescales for completion so that people live in a comfortable well maintained environment. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 3 Information gathered as part of the assessment process needs to be expanded on to evidence the level of support required ensuring people are only placed at the home if their full needs can be met. Staffing levels need to be kept under review to ensure that there are sufficent staff at all times to meet the needs of people living at the home More detailed records need to be maintained with regards to health and safety checks carried out within the home to ensure the environement is safe and people are not placed at risk. 2 27 3 38 Care Homes for Older People Page 28 of 29 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!