Inspection on 25/10/05 for Park House

This inspection was carried out on 25th October 2005.

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 found no outstanding requirements from the previous inspection report, but made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Park House 20/09/07

Park House 16/06/06

Park House 06/07/05

Park House 10/03/05

Park House 15/07/04

Similar services:

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Norbury Crescent (30)

Edenvale

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Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Park House 157 Park Lane Hornchurch Essex RM11 1EH Lead Inspector Ms Rhona Crosse Unannounced Inspection 26 October 2005 09:40 Park House DS0000027870.V259620.R01.S.doc Version 5.0 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 DS0000027870.V259620.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 Adults 18-65. 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 DS0000027870.V259620.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Park House Address 157 Park Lane Hornchurch Essex RM11 1EH 01708 707370 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) Mr Michael Joseph Prior Mrs Harjinder Kaur Prior Mrs Harjinder Kaur Prior Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Park House DS0000027870.V259620.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd June 2005 Brief Description of the Service: Park House is set in a residential area of Hornchurch close to Romford. There are no parking restrictions on the roads around the home. The home offers 24 hour care to 5 adults with learning disabilities. At present only female service users are accommodated. All accommodation is in single rooms. Park House DS0000027870.V259620.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced therefore the home did not know the inspector was coming. The inspector arrived at 09.40 (the inspector had made an unannounced visit to the home the previous week, but all the service users and staff were out that day). The service users were beginning to make preparations with the staff for their two week holiday abroad and were all looking forward to the trip. As this is the homes second statutory inspection not all of the standards were inspected, only the remaining core standards that were not inspected at the last inspection were inspected during this inspection. What the service does well: What has improved since the last inspection? What they could do better: Maintenance of the downstairs bathroom and the upstairs shower room require refurbishment and repair to being them up to the National Minimum Standards. This must be addressed, service users should not have to use facilities that are below the National Minimum Standards. The grounds of the home require some gardening maintenance. The proprietor stated that as there had been a lot of rain recently and this is why the grass requires cutting. However both the front and the back garden require weeding. The crazy paving steps up to the front entrance have pointing that requires to be renewed as this is cracked and crumbling. Park House DS0000027870.V259620.R01.S.doc Version 5.0 Page 6 One service user requires shelving to be provided to display personal possessions that are stored in boxes. Goal setting must form part of the care planning process these must record the progress of service user to enable them to reach their potential and the home to evidence the work that they are doing to improve the quality of life for service users. This is an unmet requirement from the last inspection. Staff training must be improved. All staff must have basic first aid training, basic food and hygiene training and training for the protection of vulnerable adults. Due to the current needs of the service users all staff must also have training in dealing with challenging behaviour. Any staff who have not received the above training must do so. Staff training was a requirement at the last inspection that has not been complied with. Staffing levels were appropriate at the time of the unannounced inspection, however when the staff rota was inspected it was observed that there is a ½ hour where there is only one staff member on duty in the morning. This must be addressed so that 2 staff are on duty throughout the waking day. 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 DS0000027870.V259620.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Park House DS0000027870.V259620.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: The have been no vacancies since the last inspection therefore the standards were not reassessed. The core standards were met at the last inspection. Park House DS0000027870.V259620.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 8, 10 Work needs to be completed to evidence that the home is working towards assisting service users to reach goals set and reach their potential to improve the quality of their lives. EVIDENCE: Whilst there are detailed care plans, there is no goal setting to show the work that the home is doing to improve the daily living skills service users have and build on their potential. This is an outstanding requirement from the last inspection that has not been achieved. This must be complied with within the new timescale set from this inspection. Service users are involved in the day to day life of the home. However their abilities do not allow them to be involved in the policy and procedure making of the home or have representation in the management structures. Service users know that information is held about them and could identify their files although they did not have a clear understanding of why these need to be kept. One service users said “I know they write things in my file because they Park House DS0000027870.V259620.R01.S.doc Version 5.0 Page 10 tell me, the staff have to know how I am”. “An accident I had at the centre was recorded they have to do that, that’s in the accident book”. Service users are able to share information in confidence with staff and all staff have to sign a confidentiality agreement. Only one service user is able to understand the very basics of confidentiality and said “if something was not right and I told staff they would tell Jinder if I was not being looked after properly, if it was something else they don’t need to tell her”. The service users rely very strongly on the manager/proprietor for their well being. The manager/proprietor should be congratulated on enabling service users to ‘feel safe’ and be confident in speaking out about anything within the home. Park House DS0000027870.V259620.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 15, 16 and 17. These standards are well met and promote independence and choice giving service users as full a life as possible. EVIDENCE: Service users are supported to use all the facilities in the local community and are well know locally. Outings take place a weekends as well as during the week. Staff assist service user to go to a local Church and a Church club on a Saturday afternoon. Service users are able to lock their rooms if they wish, but not all choose to do this. All service users have free access to their rooms and the rest of the home at all times “it’s our house we can do what we want,” one service user stated in a conversation with the inspector. Staff were seen to use service users chosen for name when they addressed them and treated them with respect. Park House DS0000027870.V259620.R01.S.doc Version 5.0 Page 12 Menu’s were available at the home and these showed a range of food is provided. Any changes to the menu or individual choice is recorded. One service user is being encouraged to loose weight and a healthy eating is taken into consideration. Another service user who would refuse to eat at times (which in the past has become a medical problem) is quietly encouraged to eat appropriately with a lot of effort from the staff. Service users are encouraged to keep links with family and friends and all are encouraged to visit. Service users are able to meet and make friends with people of their own choice. Relationships are supported and there are guideline for staff to refer to in relation to any intimate relationships that service users may have in the future and enable them to make safe supported choices about their development. Park House DS0000027870.V259620.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 21 The information for standard 21 was not available at the time of inspection as this was said by the manger to be being updated and held elsewhere. All information must be available at all times for inspection to ensure that the home meets the needs of the service users and complies with the Regulations and National Minimum Standards. EVIDENCE: Although the manager stated that information about the wishes of service users at the time of death was sought, there was no documentary evidence of this at the home on the day of the inspection. This standard is therefore not met. The manager stated that this information was being updated onto the new care plans outside of the home on her computer. All documentation relating to the care of service users must be available for inspection at any time. Park House DS0000027870.V259620.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The home had a complaints procedure and service users are aware that they can make a complaint if they are not happy about something. There were no complaints recorded in the complaints book. Due to the complex needs of service users the home must be able to evidence that staff are can deal with ‘self harm’ therefore training in dealing with challenging behaviour must be provided to ensure the safety of all service users. EVIDENCE: In discussion with service users they said “if I am not happy I tell the staff they will sort it out”. “I tell Jinder if I am not happy she helps me, you can tell her anything”. “We are well looked after here I have no complaints”. “Jinder or Michael will sort it out, we tell them”. Although service users feel confident that any problems would be dealt with, one service user will ‘self harm’ and exhibits this behaviour from time to time. There had been several situations recently where a service users action had lead to ‘self harm’. Although these had been dealt with appropriately, not all staff have received training in dealing with challenging behaviour. This must be addressed to ensure the ongoing safety of all service users. Park House DS0000027870.V259620.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28 and 30. Standard 29 does not apply to this home. The home is not suitable for anyone with a physical disability therefore standard 29 does not apply to this home. Maintenance work and refurbishment is required in the downstairs bathroom and the upstairs shower room. Maintenance of the grounds is also required. Service users should not have to use facilities that are below the National Minimum Standards. This impacts on their quality of life. Infection control was poor on the day of the inspection this implications for the health of service users. EVIDENCE: The communal areas of the home and the bedrooms are in good order. However the bathroom downstairs has ‘blown’ tiles around the bath. The area where the tiles are loose and bowed out from the wall is extensive and new ceramic tiling may be required after the wall behind is treated for damp. The upstairs shower room requires refurbishment. The shower cubicle needs to be replaced. At the time of the inspection the electrician had been putting new lighting in the bathroom to meet with the new electrical regulations and ceiling now has several holes in it. The shower room requires the ceiling making good Park House DS0000027870.V259620.R01.S.doc Version 5.0 Page 16 where lights have been removed. The walls and woodwork require painting and decorating. On inspection of individuals bedrooms (one bedroom was not inspected as this room was locked and the service user was not at home), showed that these rooms were very individual and held lots of personal possessions. One service user requires shelving to be put into her bedroom to enable personal possessions held in cardboard boxes to be displayed. This must be addressed. The laundry room was inspected. Linen and dirty clothing was spilling out of the laundry room and onto the carpet in the upstairs hallway. This is poor infection control. Laundry should not be placed on the laundry room floor but should kept in the individual’s laundry baskets until ready to be washed. A sample of urine used for diabetes monitoring was left in a bedroom. This is poor practice. If the service user does not dispose of this urine this must be carried out by staff. The gardens to the front and the rear of the property require maintenance. The grass was long and required mowing. The proprietor stated that this was due to the wet weather recently where there has not been an opportunity to cut the grass. Weeding is required to be carried out to the front garden as this is overgrown. The crazy paving steps up to the front entrance has pointing that is cracked and crumbling this needs to be repaired. Park House DS0000027870.V259620.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34, 35 and 36. There has been an improvement in the recruitment and selection information held for staff. It was a requirement at the last inspection as not all records that are required by legislation were held. Staff training was also a requirement that at present remains unmet from the last inspection further time will be given for compliance with this requirement but this must be complied with within the new timescale to ensure the ongoing wellbeing of service users. EVIDENCE: A random selection of staff files were inspected. It was observed that there had been improvements in the recruitment and selection documentation. Staff are now attending NVQ level 2 training, and one staff member holds this qualification. It was a requirement at the last inspection that all staff have to attend statutory training, food hygiene, manual handling and basic first aid. The manager stated that a date was to be set for this training to take place, however the date for compliance was the 30/9/05. This must be addressed within the new timescale or formal action may be taken against the home. Park House DS0000027870.V259620.R01.S.doc Version 5.0 Page 18 Not all staff have attended training in dealing with challenging behaviour, this training must be provided. Staff must be appropriately trained to meet the individual needs of the service users accommodated. Staff have received formal written supervision sessions. It was recommended that the manager keeps a chart of when supervision sessions have taken place to ensure that all staff receive the minimum of 6 supervision sessions within any one rolling year. Park House DS0000027870.V259620.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. The home is not being run in the set interests of service users’ as maintenance of both bathrooms is poor. The current service users accommodated do not have the abilities to have input into Standard 39. Standard 42 is well managed ensuring the safety of service users. EVIDENCE: Standard 37 relating to the home being run for the benefit of service users is not met due to the poor maintenance of the bathrooms where these rooms do not meet the National Minimum Standards, therefore this has a detrimental affect on service users environment. These rooms are below the National Minimum Standards. The health and safety documentation was inspected. The 5 year electrical safety certificate was dated 3/9/05 and the annual portable appliance test was dated 13/6/05. The fire alarm service was carried out on the 3/9/05 along with the emergency lighting. Fire drills are taking place and the last drill is recorded as taking place on the 21/10/05 the fire extinguisher received their annual Park House DS0000027870.V259620.R01.S.doc Version 5.0 Page 20 check on the 13/7/05. The Legionella test of the water system was dated 2/8/05. The accident book was appropriately completed with information cross referenced with the daily records. Park House DS0000027870.V259620.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x X x x x Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 x 3 x 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 1 2 3 3 3 N/A 2 LIFESTYLES Standard No Score 11 x 12 x 13 3 14 x 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 X X 2 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Park House Score 3 X X 2 Standard No 37 38 39 40 41 42 43 Score x X N/A X X 3 x DS0000027870.V259620.R01.S.doc Version 5.0 Page 22 No Are there any outstanding requirements from the last inspection? 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 Standard YA6 Regulation 15(1) & (2) Requirement Goals for achievement must be set to enable service user to reach their potential. These should be recorded in the care planning. Information about the needs of service users at the time of death must be added to the care plans and be available for inspection at any time All staff should be provided with training in dealing with challenging behaviour. The ground to the front and back of the building require the grass cutting and weeding of borders. The entrance steps made out of crazy paving has pointing that is cracked and crumbling. The pointing must be replaced. The ceramic tiles on the walls in the downstairs bathroom need to be replaced as they have ‘blown’ and are standing proud of the walls surface. The upstairs shower room needs refurbishment, the shower requires maintenance to the sealed edges of the shower door and the room requires painting DS0000027870.V259620.R01.S.doc Timescale for action 30/01/06 2 YA21 15(1) & (2) 30/01/06 3 4 5 YA23 YA24 YA24 13(4)(c) 23(2)(o) 23(2)(o) 20/02/06 20/12/05 20/12/05 6 YA27 23(2)(b) 20/12/05 7 YA27 23(2)(b) 30/03/06 Park House Version 5.0 Page 23 and decorating. 8 9 YA28 YA30 Shelving is to be provided in one service users room to enable the display of personal possessions. 13(3) Laundry should not be allowed to spill out onto the carpet in the hallway this is poor infection control. 13(3) The urine samples used for testing must be disposed of by staff after the test has taken place. 18(1)(c)(i) Staff must have training in basic first aid, POVA, food hygiene 18(1)(a) There must be two staff on duty throughout the waking day. 16(2)(c) 20/12/05 20/11/05 10 YA30 26/10/05 11 12 YA32 YA35 28/02/05 30/11/05 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 YA36 Good Practice Recommendations It is recommended that a chart identifying the times that supervision takes place is drawn up to assist the manager to monitor that 6 supervision sessions per year have taken place with all staff. Park House DS0000027870.V259620.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 DS0000027870.V259620.R01.S.doc Version 5.0 Page 25 - 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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