Inspection on 26/09/08 for Park House

This inspection was carried out on 26th September 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Park House 16/10/06

Park House 03/02/06

Park House 09/08/05

Park House 03/03/05

Park House 21/10/04

Park House 11/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 17/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Park House Park House Tyringham Nr Newport Pagnell Bucks MK16 9ES     The quality rating for this care home is:   two star good 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: Chris Sidwell     Date: 2 6 0 9 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 28 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 28 Information about the care home Name of care home: Address: Park House Park House Tyringham Nr Newport Pagnell Bucks MK16 9ES 01908613386 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Mr Edward Nigel Broadway,Mrs Gillian Elaine Broadway The registered provider is responsible for running the service Name of registered manager (if applicable) vacant Type of registration: Number of places registered: care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The room at the back of the property is to be used to accommodate the identified service user only. The suitability of the accommodation for this service user is to be reviewed 3 monthly with a copy of this review being sent to the NCSC. This home is registered for 24 older people inlcuding 4 people over the age of 65 with dementia. When the room is vacated by the identified service user- the proprietors will need to apply to the NCSC for its re-registration. Care Homes for Older People Page 4 of 28 Over 65 0 24 4 0 Date of last inspection Brief description of the care home Park House is situated in the country estate of Tyringham; it is 3 miles from the town of Newport Pagnell, which provides a range of shops and community facilities. Park House has 24 single bedrooms of which 19 have en-suite facilities; accommodation is provided over two floors. A shaft lift is available to assist residents with access to the upper floor. The home has lovely grounds including two courtyard gardens. Care Homes for Older People Page 5 of 28 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: two star good 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 last key inspection of this service was undertaken in 16th October 2006. An Annual Service Review was undertaken on the 13th March 2008. This inspection was conducted over the course of three days and included an unannounced visit to the home. The key standards for older people’s services were covered. Information received about the home since the last inspection was taken into account in the planning of the visit. Prior to the visit, the manager completed an annual quality assurance self-assessment and questionnaires were distributed to residents, visiting health and social care professionals and staff. Eight residents or their families, eight members of staff and four healthcare professionals, including two general practioners returned questionnaires. Residents and families were also spoken to on the Care Homes for Older People Page 6 of 28 days of the unannounced visit. Discussions took place with the manager, care and ancillary staff. Care practice was observed. A tour of the premises and examination of some of the required records was also undertaken. The homes approach to equality and diversity was considered throughout. What the care home does well: What has improved since the last inspection? What they could do better: The proprietor should ensure that all residents have a contract or a statement of their terms and conditions if they are supported by the local authority or health services. A controlled drugs cupboard must be provided to ensure that controlled medication is stored in line with legislation governing the storage of medication and to ensure that residents medication is stored safely. Information about the storage of medicines, including controlled drugs, is available from the Royal Pharmaceutical Society and on their website www.rpsgb.org.uk and from the Commission for Social Care Inspection on their website www.csci.org.uk. The practice of keeping confidential records about care given to residents in a general book should be reviewed as this may lead to a breach of individual privacy if a resident Care Homes for Older People Page 8 of 28 or their family wishes to see their own records. The proprietor must clarify the management arrangements for the home and ensure that application is made for a manager to register with the Commission for Socal Care Inspection. 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 28 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 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is information available to potential residents and their diverse social and care needs are identified with them, prior to their move to the home, to ensure that they can be met. Evidence: The home has a statement of purpose and service users’ guide. All of the residents, or families, who returned the questionnaire, said that they had received information about the home and the families spoken to said that they had been made welcome at the home and invited to look around before their family member moved to the home. One said I had a tour which really helped me get a feel for the place, the atmosphere etc and to talk to other residents. The deputy manager confirmed that she met residents to assess their needs and agree that they would be able to meet them before they moved to the home. Families Care Homes for Older People Page 11 of 28 Evidence: spoken to confirmed that someone had visited their relative before they moved. Copies of the assessment were seen in the files. Residents cultural and spiritual needs were identified. Most of the residents or families who returned the questionnaires said that they had a copy of their contract with the home. Three however said that they did not. The proprietor should ensure that all residents have a contract or a statement of their terms and conditions if they are supported by the local authority or health services . Care Homes for Older People Page 12 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents personal, healthcare and medication needs are met and in a manner that protects their dignity. Evidence: All residents had care plans. The care of two residents was followed through. They had detailed care plans, which showed attention to their health and personal care needs. They also showed attention to detail and described residents individual likes and dislikes. They had been updated regularly. Daily records about care given to all residents are kept in one book and the manager said that important information would be transfered to the individuals care plan. This could be a breach of individual privacy and should be reviewed. There was evidence in the care plans that the general practitioner visits regularly and that residents see other members of the healthcare team. Two general practitioners returned the questionnaires and said that they felt that individuals healthcare needs were met by the service. Care Homes for Older People Page 13 of 28 Evidence: Residents told us that they always or usually received the care and support that they needed and commented that staff are very kind, I am well looked after and over and above the call of duty, excellent care. There were medication policies and procedures in place. Staff have had training in medication administration. The staff spoken to said that medicines were not given covertly and if a resident did not wish to take their medication this would be recorded and discussed with the resident and the doctor. The medication administration records were completed accurately and there were records of medication received by the home and leaving the home. The home does not have a controlled drug cupboard, which must be purchased. Information about the storage of medicines, including controlled drugs, is available from the Royal Pharmaceutical Society and on their website www.rpsgb.org.uk and from the Commission for Social Care Inspection on their website www.csci.org.uk. Residents told us that the staff listened to them and were always polite. One said they always knock on my door before they come in. Staff confirmed that personal care was always given in resdents rooms. Care Homes for Older People Page 14 of 28 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. Residents are supported to choose how they spend their day and to keep in contact with relatives and friends. The standard of food is good and residents nutritional needs are met. Evidence: Residents told us that they could spend their day as they wish. On the day of the unannounced visit some had chosen to stay in their rooms. An armchair exercise session was taking place in the lounge, which residents were obviously enjoying. The staff said that they arranged a programme of activities which residents could join in if they wished. The staff said that they could support residents who wished to go to church. Residents are supported to visit the local town if they wish and two gentleman regularly visit the local pub. The home is isolated, although in beautiful surroundings and transport is required to go out. The proprietor said that she was planning to introduce more 1:1 activity in the home for those who did not want to join in group activities and to engage more in community based events which will require forward planning. Residents told us that they enjoyed the meals, making comments such as the food is Care Homes for Older People Page 15 of 28 Evidence: really good, all tastes are catered for and the cook knows what I like. The menus were varied and most food is home cooked. There were two fresh vegetables at lunch and fruit was incorporated into many sweets. All cakes are home made. The chef was knowledgeable about individual residents likes and dislikes and was able to accommodate them. She also was aware of those who needed a special diet for health reasons. She said that she did not have anyone who had special cultural requirements but would endeavour to accommodate these if the need arose. Care Homes for Older People Page 16 of 28 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. There are complaints procedures in place and residents concerns are taken seriously and addressed promptly. Procedures are in place to safeguard service users from abuse. Evidence: There are complaints, safeguarding and whistle blowing policies and procedures in place. The training records showed that staff have had training in safeguarding older people. The home had a copy of the local multi agency policies and procedures and were aware who to contact if they had any concerns. The staff were clear that they would have no hesitation in speaking to the manager or the owner if they had concerns about a resident. Residents told us that they knew who to speak to if they had any concerns. One said however that she would like staff to wear a name badge. Another said any of the staff will direct you to the owner but no need as it a happy home. One family member said any concerns are dealt with quickly. The proprietor said in the Annual Quality Assurance self assessment that she had received two complaints which she had addressed. The Commission for Social Care Inspection has been notified of two complaints which have been addressed. One was investigated with the help of an Age Concern advocate and resolved. The Commission Care Homes for Older People Page 17 of 28 Evidence: for Social Care Inspection has not been notified of any safeguarding allegations notified to the local authority which is the lead agency in these matters. Care Homes for Older People Page 18 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained and provides an attractive, comfortable and safe place for residents to live. Evidence: The home is set in landscaped parklands with extensive rural views. It is homely and there has been an ongoing programme of refurbishment. The hallways have been redecorated and have new carpet since the last inspection. Two new profiling beds have been bought for residents who need more care in bed and who may need help to move in bed. Residents are encouraged to bring small items of furniture and to personalise their room, which many had chosen to do. The proprietor said that she was intending to improve access for people with disabilities by having paving laid on parts of the gravel drive for wheelchairs. There are control of infection policies and procedures in place. The training records show that staff have had training in infection control. The washing machines were not working on the day of the unannounced inspection and laundry was being sent to the nearby sister home, Lathbury Manor. The proprietor said that the washing machines would be repaired. The Environmental Health Authority has inspected the kitchens and awarded 4 star rating for cleanliness and food safety. Care Homes for Older People Page 19 of 28 Care Homes for Older People Page 20 of 28 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. There are sufficient staff who have had training in relevant skills to meet residents needs. Recruitment practices should be more systematic to ensure residents are protected from unsuitable carers. Evidence: There were 23 residents in the home on the day of the unannounced visit. There were 6 care staff on duty. The proprietor said that she aimed to have 6/7 care staff on duty in the morning, 4/5 in the afternoon and evening and 2 during the night. The residents spoken to said that the staff were kind and helpful. They told us in the questionnaires that staff were always or usually available to help them. Care staff who returned the questionnaires also felt that there were sufficient care staff to meet peoples needs and when asked what they felt the home did well, several commented that they felt that they were able to offer person centred care. There is an active training programme. Training records show a wide range of training opportunities. In addition to training in safe working practices some staff have had the opportunity for training in the management of hearing aids, catheter care,diabetes, falls prevention, dementia awareness and infection control. Training is sourced from Milton Keynes Council and distance learning opportunities from Milton Keynes College. There is an in house induction programme and staff complete the foundation course Care Homes for Older People Page 21 of 28 Evidence: for the National Vocational Qualifications (NVQ) in care if they do not hold this qualification. The recruitment records of three members of staff were checked. They showed that in general checks as to the suitability of care staff are undertaken before they commence work. Two references had been sought and a Criminal Records Bureau disclosure had been received before the staff member started work. One record did not contain a reference from the last employer but from a temporary employment agency , one did not hold a copy of the staff members passport and one did not hold a copy of the staff members work permit. Not all files held records of the interview. The proprietor said that these would be kept at the nearby sister home. It is recommended that all records pertaining to individual staff are kept together in one folder and that interview records are kept and any gaps in employment history are explored. The recruitment files should also be checked to ensure that they all hold copies of the required documentation. Guidance about recruitment practice is available on our website www.csci.org.uk. Care Homes for Older People Page 22 of 28 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. The day to day management arrangements in the home meet residents needs and people told us the management team was responsive to their wishes. The proprietor must however ensure that application is made for a manager to register with the Commission for Social Care Inspection, to ensure that the home meets the legislative requirements designed to protect residents from an unstable management arrangements. Evidence: The home has not registered a manager with us since the last inspection. The proprietor said that she visits the home on a regular basis and has appointed an acting manager and deputy manager who manage the care on a day to day basis. She is the registered proprietor and manager of another home nearby. The atmosphere in the home appeared to be open and welcoming. The deputy manager who was on duty at the time of the unannounced visit was knowledgeable about the care of residents and staff said that there had been an improvement in the care offered since her Care Homes for Older People Page 23 of 28 Evidence: appointment. The proprietor must however decide on a permanent, sustainable management structure for the home and the a manager must apply for registration with the Commission for Social Care Inspection. Both the proprietor and deputy manager said that they had an open door approach and that issues raised by residents or staff would be addressed on an ongoing basis. Residents told us in the questionnaires that staff listened and acted upon what they say and most were complementary about the care. One said this home should be praised, everything that could be done to help (my family member) settle in has been and we have been supported from the start. There was evidence that the needs of people with disability were addressed with help for those with partial sight and hearing loss. There is some ongoing audit of care plans and other procedures although this could be implemented in a more systematic manner to ensure all aspects of the homes management is audited on a regular basis, including medicines management and recruitment practices. Questionnaires have been distributed to residents and their families in the past, as part of the quality assurance programme. The proprietor said that she was about to do that again. The home does not manage any money on behalf of residents. There are facilities for small amounts of money to be kept for safekeeping at the home and records are kept. There are health and safety policies in place and training records showed that staff had had training in safe working practices. Care Homes for Older People Page 24 of 28 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 25 of 28 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 9 13 A controlled drugs cupboard must be provided. To ensure that medicines are stored safely and correctly and to comply with legisation on the storage of controlled drugs. 28/11/2008 2 29 19 Recruitment files must 28/11/2008 contain copies of the documentation specified in Regulation 19 and schedules 2 and 4 of the Care Homes Regulations 2001. To ensure that residents are protected from unsuitable carers. 3 31 8 The proprietor must ensure that an application is made for a manager to register with the Commission for Socal Care Inspection. To ensure that the home meets the legistlative requirements designed to protect residents from 12/12/2008 Care Homes for Older People Page 26 of 28 unstable management arrangements. 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 The proprietor should ensure that all residents have a contract or a statement of their terms and conditions if they are supported by the local authority or health services. The practice of keeping confidential records about care given to residents in a general book should be reviewed as this may lead to a breach of individual privacy if a resident or their families wish to see their own records. Staff records should be kept together. Interview records should be kept and gaps in work record explored at interview. Guidance about recruitment practice is available on our website www.csci.org.uk. 2 7 3 29 Care Homes for Older People Page 27 of 28 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 28 of 28 - 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!