Inspection on 04/06/07 for Park House

This inspection was carried out on 4th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Park House 04/05/06

Park House 02/02/06

Park House 31/05/05

Park House 26/11/04

Park House 09/06/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Park House 2 Richmond Road Stockton-on-Tees TS18 4DS Lead Inspector Brenda Grant Key Unannounced Inspection 09:45 4th June 2007 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park House Address 2 Richmond Road Stockton-on-Tees TS18 4DS 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) 01642 674703 dash377@ntlworld.com Mr Jack Elliott Mrs Geraldine Elliott Mrs Margaret Lavinia Horner Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home can allow one person under the age of 60 years to be admitted to the home. 4th May 2006 Date of last inspection Brief Description of the Service: Park house is registered as a care home for 18 older people and is situated in a quiet residential road in Stockton. The home has attractive and well-kept gardens and a private paved area to the rear of the building. The home is a short bus ride from the town centre and a few minutes walk from Ropner Park. Accommodation is provided in sixteen single bedrooms, nine of which have ensuite facilities. There is one double bedroom. All bedrooms meet the special requirements of the National Minimum Standards. Communal space comprises a dining room and two lounges, one of which has been designated a smoking lounge. The fee, for residents at Park House, is £353. Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was an unannounced inspection. We assessed the information from: the Pre-Inspection Questionnaire and we carried out a visit to the home. The visit took place over one day, six hours fifteen minutes in total. Discussion took place with residents, staff and the senior person at the home, the provider’s son. We looked around the home and gardens as well as examining a number of records which included; residents and staff files, health and safety and maintenance checks and complaints and kitchen documentation. The findings from the inspection were of the home adequately providing a care service, with many of the National Minimum Standards being met but there are some areas where improvements need to be made. What the service does well: What has improved since the last inspection? Park House has been redecorated, to improve the appearance of the inside of the home for the residents. The home is taking steps to make sure the requirements of the local fire service are met; this is by updating the Fire Risk Assessment and installing smoke seals to some of the fire doors. Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards: 3 & 6 Resident’s needs are assessed before moving to the home and they are assured those needs will be met. EVIDENCE: Residents who are funded by the local authority have assessments, carried out by a care manager, which are shared with the home. For those and privately funded residents, the manager carries out a further assessment, so that it can be determined whether the needs of the person could be met at Park House. The assessment includes details of: health, social and personal needs as well as social interests, hobbies and religion. Potential residents are involved with the assessment process and, where necessary, relatives also have the opportunity to give their views. The home does not offer intermediate care therefore standard six does not apply. Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Standards: 7, 8, 9 & 10 Resident’s health, personal and social care needs are not fully recorded in Care Plans. The home’s procedure for managing medicines had changed but the procedure had not been reviewed and updated. Residents are treated with respect and their right to privacy is upheld. EVIDENCE: The home develops Care Plans for each resident. There is basic information about the person’s care needs and the plans are regularly reviewed. The Care Plans gave general details about particular areas of need but some of the information did not specifically apply to the individual residents. Care Plans did not provide specific information about how each resident’s care needs were to be met. There was a resident who was regularly checked, by care staff, during the day but this information was not recorded. Despite this, care staff said they knew the checks had to be carried out. The Care Plans did not record that Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 10 the views of people who use services are sought in the way personal care is delivered. Care Plans included a Risk Assessment but when a risk was identified as high, or very high, there was no further documentation to inform how those risks were to be managed; to reduce those risks to an acceptable level. After the inspection ‘site’ visit, the senior person informed the Commission for Social Care Inspection that Risk Assessments were at the home but they could not be found during the ‘site’ visit and they were not readily available to staff. Resident’s files had separate information of GP and district nurse visits but other healthcare visits and appointments were in the general information. Residents healthcare needs were being met but the reader, of the record, could not readily see the regularity of visits for treatment from: opticians, chiropodists, dentists and other healthcare specialists. The home’s written procedure, for managing medicines, was not the procedure adopted by the home. We queried why there were many medicine pots with resident’s names on them. The senior care assistant informed, the pots were used for transferring medication from various packages, including medicines in the monitored dosage system, to the pots. The senior care staff, who administered the medication, was observed taking a tray containing many pots to the residents who were located around the home; in the dining room, a lounge and bedrooms. We informed a senior person at the home, that by having so many pots on a tray there may be a chance for error when staff are administering medicines. The home’s procedure informs, staff should carry out administration of medicines to one resident at a time and repeat this practice until all residents have received their medicine; this is good practice. We asked the home to reassess and update their procedure, which named a monitored dosage system the home no longer uses, for managing medicines. That must include: information about use of the present monitored dosage system and good practice for administering medicines and the home is to make sure the procedure is followed. The medication administration record was examined and it was found there were a few gaps in the record. Staff files confirmed staff has completed medication awareness training. Staff were observed being respectful to residents and knocking on bedroom doors before entering the room. The senior person at the home informed resident’s right to privacy is respected. Residents spoken with confirmed this and said, “I can stay in my bedroom or go to the lounges when I want”, “Staff talk to me the way I want to be spoken to” and “They (the care staff) are very good and caring”. Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards: 12, 13, 14 & 15 Residents live their lives as they wish and residents maintain contacts with families and friends. Residents have choice and control over what they do. The home provides a varied and balanced menu and there is flexibility when and where residents wish to have their meals. EVIDENCE: Residents spoken with informed they live their lives as they wish. Staff said they try to find out about residents interests and provide for them at the home. Some of the home’s resident surveys informed that residents enjoyed the activities offered at the home and residents comment where they would like to go if outings were to be planned. The senior person at the home said, the home provides for resident’s religious needs by arranging regular ‘communion’ to take place. However it was uncertain which religious sect this was offered from and whether all resident’s religious needs were being met. Residents said, staff sometimes accompanied them to the local shops or the park nearby. One resident who had been to the Metro Centre said, “It was a great experience”. Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 12 Residents and staff said, relatives and friends were always made to feel welcome when they visited the home. Staff said the home has regular contact with resident’s families. One resident said, “Staff are always friendly when my family call to see me”. Residents said, they felt they were in control of their lives. One resident said, “I am happy living here and I can do what I want”. Residents said, they were able to bring their personal possessions and have their bedrooms arranged as they wish. The home accommodated for residents who wished to: get up early or late, stay in their bedrooms or go to communal rooms and have meals where the resident chose. The senior person informed, that residents were allocated bedrooms depending on the resident’s physical capability of being able to move around various areas of the home. The residents, who were less able to move around, had their bedrooms on the ground floor. The home’s menus were examined and there was a good variety of food offered at the home. All residents spoken with said, the food was very good. The mealtime, lunch, was observed; the food was well presented and residents were not hurried with eating their food. On the day of the inspection ‘site’ visit the menu displayed in the dining room was not the food for that day. The cook said, he has been updating menus and trying out different meals that were satisfactory to residents. The senior person said, he has not yet had time to have the menus printed in an appropriate format for displaying in the dining room. The food at the home was of fresh fruit and vegetables, meat and other foods were of a very good quality. All residents spoken with said, they liked the food. Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards: 16 & 18 Residents are confident their complaints will be listened to, taken seriously and acted upon. Residents are protected from abuse by the home’s policies and procedures. EVIDENCE: The home has a satisfactory complaint’s procedure. Residents spoken with informed, they did not have anything to complain about but residents were confident any complaint would be appropriately investigated and dealt with. The home has a book for recording complaints but there were no entries as no one had made a complaint. The home has procedures for protecting residents from abuse. Staff records confirmed staff had completed training for safeguarding vulnerable adults. Staff said, they knew of the procedures to follow if there was an allegation of abuse to a resident. Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards: 19 & 26 In the main, residents live in a safe and well-maintained environment. The home is clean, pleasant and hygienic and free from offensive odours. EVIDENCE: Park House provides a homely and comfortable environment for the residents. The senior person informed, the home had been redecorated and residents commented, they thought the home was “Nicely kept”. The senior person informed that residents are not consulted on the colour schemes when redecoration takes place around the home. The garden areas were well maintained and attractive, with rose-beds and flowering plants and seating was available for residents who wished to sit outside. One resident said, “The roses are lovely”. The senior person said, some of the double glazed windows needed Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 15 to be replaced because the windows were misted up and he was hoping to replace those windows in the future. The home’s maintenance records were examined. The requirements of the Environmental Health Department had been met. The senior person informed, a consultant was making arrangements so that the requirements of the local Fire Service would be addressed. The weekly checks of the fire alarm was recorded but it did not give details of which fire point had been checked, the Fire Risk Assessment was being updated and the home was making arrangements to have smoke seals on some of the fire doors. The home was clean, pleasant, hygienic and free from offensive odours. Laundry facilities were on the lower ground floor and washing and drying machines were seen to be satisfactory. Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards: 27, 28,29 & 30 Resident’s needs are mostly met by the numbers and skill mix of staff who are trained and competent to care for the residents at the home. Residents are protected by the home’s recruitment procedures. EVIDENCE: On the day of the inspection ‘site’ visit there was sufficient staff on duty to meet the needs of the residents living at the home. The senior person said, the home had a high staff turnover and there was regular recruitment of new care staff but the home has some care staff who have worked at the home for a few years. The high turnover of staff did not seem to adversely affect the quality of the individual care and support that people who use the service receive. There were seven of the fifteen care staff who have successfully completed the National Vocational Qualification at Level 2. The senior person said, “Last week a care assistant, who had that qualification, had left the home and he was hoping to recruit a new member of staff who had the National Vocational Qualification Level 2. Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 17 Staff spoken with, and staff files, confirmed the home follows the recruitment procedure. The files contained the appropriate checks and references. Staff’s files confirmed staff had completed basic and further training and four care staff had completed extra training; for dementia awareness. Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Standards: 31, 33, 35 & 38 Residents and other interested parties views are considered when plans are made to develop the service but staff and residents are not included with the running of the home. Resident’s personal monies are safeguarded by the home’s procedures. In most, but not all, areas the health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: The manager has the appropriate care and management qualifications and experience to run a care home for older people. Staff said, the manager and the providers gave good support when it was needed. Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 19 The home carries out quality assurance surveys; residents and/or their relatives completed questionnaires. The home has not devised a report to compile the results of the survey. The home does not have staff or resident’s meetings. More work is needed to consult with staff and residents about the running of the home, so they are included with any improvements and developments that take place. The home does not have a written business/development plan that demonstrates how the home’s service will be improved. The senior person said, there were plans for improvement but this is not recorded in a written document and there are no firm timescales when improvements will happen. There was no documentation to demonstrate that the home carries out regular self-monitoring checks or internal audits of the service. The senior person said, residents were encouraged to look after their own money and residents are provided with a lockable box, for safe keeping of valuables. The home was not involved in financial transactions on behalf of residents. Most of the health and safety requirements are met. Staff had completed health and safety training and the home provides protective clothing for staff’s use. Electrical equipment is checked and there is up to date documentation for Control Of Substances Hazardous to Health. On the day of the inspection ‘site’ visit fire safety requirements were being updated, plans were in place to develop Fire Risk Assessments and to make fire safety adaptations around the building. It was confirmed that the recommendations of the Environmental Health Report have been addressed. Records are generally satisfactory. The home keeps records of all accidents but the records were not kept as directed on the accident recording sheets. The home regularly checks the hot water outlet temperatures, in resident’s accommodation, which is controlled by thermostatic valves. However the home does not monitor, or actively take measures, to check and record that hot water is stored to a minimum satisfactory temperature of 60 degrees Centigrade; to reduce the risk of Legionella. Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Resident’s individual Care Plans must give information only for that resident. There should be details of resident’s care needs and how those needs are to be met. Unless it is impracticable to do so, residents or a representative must be consulted and have the opportunity to give their views when there are reviews of the Care Plans. 2 OP7 13 Care Plans must include Risk Assessments that give information of the risk and how the risk is to be managed. Risk Assessments must be reviewed with the Care Plans. The manager must remove all out of date medication procedures from the procedures file. The previous timescale of 17/05/06 has not been met. Administration of medicines must be carried out in accordance with Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 22 Timescale for action 31/08/07 31/08/07 3. OP9 13 31/07/07 the home’s procedure, for the safety of residents. The Medication Administration Record must be fully completed. There must be no gaps in the record which must document all medicines that are administered to residents and give a reason if medicines have not been taken. 4. OP33 24 The home must devise a report containing details of the measures that are to be taken in order to improve the quality and delivery of the services provided at the home. The report should detail how the home: provides good quality services, takes into account the views of residents and their representatives in how services are provided. The report must include how the home responds to recommendations made or requirements imposed in this and the last Inspection Report. Accident documentation must be kept as directed on the accident recording sheets, so that they are as a permanent record of any accidents that happen at the home. 31/08/07 5. OP38 17 31/08/07 6. OP38 13 The home must check and record 31/08/07 that the stored hot water is at a minimum temperature of 60 degrees Centigrade, to reduce the risk of Legionella. Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 23 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 OP12 Good Practice Recommendations The home should make sure resident’s religious preferences and needs are met. Park House DS0000000023.V341422.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX National Enquiry Line: 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 © 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 DS0000000023.V341422.R01.S.doc Version 5.2 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. 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!