Inspection on 23/05/07 for Park House Care Home

This inspection was carried out on 23rd May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Park House Care Home 08/05/06

Park House Care Home 14/10/05

Park House Care Home 05/07/05

Park House Care Home 23/03/05

Park House Care Home 14/03/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Park House Care Home Cinderhill Road Bulwell Nottingham NG6 8BS Lead Inspector Lee West Unannounced Inspection 23rd May 2007 10:30 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 Care Home DS0000026460.V337547.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 Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park House Care Home Address Cinderhill Road Bulwell Nottingham NG6 8BS 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) 0115 9771363 0115 9771460 Eastgate Limited Eunice Browne Care Home 47 Category(ies) of Old age, not falling within any other category registration, with number (47), Terminally ill (2) of places Park House Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th May 2006 Brief Description of the Service: Park House is a purpose built care home with 47 places, offering residential and nursing care, which includes specialist provision of palliative care. Situated in the Bulwell area, there is access to bus and tram routes into the City and to various local community facilities. The building is on two floors with lift access to the first floor. All areas are wheelchair accessible. The garden has several seating areas, with a conservatory leading onto the garden. There is ample parking in the large car park with a well maintained, front garden. The fees range from £290. for residential care to £499 for palliative care nursing. There is a £20 extra charge for en-suite bedrooms. The certificate of registration is displayed in the foyer of the home and copies of the service user handbook and previous reports are made available to anyone who wishes to see them. Park House Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit on 23rd May 2007, starting at 10.30am and ending at 4.30pm. It formed part of the inspection process, which included information gathered by interviewing residents, relatives, staff and other professionals. Also used was information from seven service user surveys and six surveys for relatives, returned to the Commission, together with responses contained in the pre-inspection questionnaire, completed by the manager and other records kept within the home and also by the commission. The method used was case tracking, where six residents were asked about their experiences and expectations of living at the home. Staff, visitors, and visiting professionals, were interviewed, records analysed and the areas of the home used by the service users were inspected. What the service does well: What has improved since the last inspection? Care plans have improved, are up to date, and are reviewed regularly with the current care needs of residents identified. Park House Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 6 Repairs to bathroom and toilet facilities have been carried out, reducing unnecessary risks to users. Staff records are now complete and contain the correct forms of identification and records of training to support suitable recruitment practices and protect residents. A training officer has been employed since the last inspection and new staff undergo a thorough induction training programme, monitored by the training officer to help maintain a competent workforce to support and protect the residents. What they could do better: Care plans must identify what assistance is needed and how it is to be met by the carers, to ensure all the healthcare needs of the residents are being met, whilst maintaining any abilities the resident may still have. Activities reflecting the interests and preferences of the residents should be put into practice regularly to promote the physical and mental well-being of all residents. The visitors’ toilet door lock to be repaired and the broken window in the new relatives’ room replaced. Routine maintenance should be kept up to date, to reduce hazards to residents and visitors, and enhance the environment. Carers must receive training appropriate to the work they are performing, including first aid training, and maintained up to date to encourage a competent workforce to support residents who need help. Regular supervision of staff must be undertaken to monitor the quality of care provided for residents, and to ensure they are carrying out the moving and handling of residents in accordance with approved techniques and current training to reduce the risk of discomfort for residents who require support on movement. Supervision should also include the professional and personal development needs of the staff member to ensure carers are competent in their roles and to provide evidence they are working in accordance with training undertaken. Please contact the provider for advice of actions taken in response to this Park House Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 7 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 Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 8 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 Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 9 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): 1, 3, 6, Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Potential residents and their relatives have sufficient information to make an informed choice about the home, with thorough assessments to ensure the home can meet their individual needs. EVIDENCE: Residents said they had been given as much information as they needed to make an informed choice to live in the home. The service user guide was informative and people spoken with said they had seen a copy of this before coming into the home. Relative and service user surveys were all positive about the information provided and one said, “we were taken for a look around the home and everything was to my satisfaction.” Park House Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 10 Thorough pre-admission assessments were seen in the records case tracked, and the residents spoken with said they had been involved with this assessment process. Residents spoken with, who were in the home for short-term care, said they were satisfied that they were helped to be as independent as possible, in preparation for going home. Park House Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 11 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): 7, 8, 9, 10, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Care plans, generally, identify the needs of residents, with procedures in place being followed, but some don’t say what staff need to do to meet these needs, which could lead to staff being unsure of the input required from them to properly support the residents. EVIDENCE: Care plans case tracked contained signed and dated records of assessment, actions to address needs, together with signed and dated reviews and daily records. One identified and explained how to support a resident who had a communication difficulty, but one plan stated “assist with washing and dressing,” with no explanation of what the resident could do for themselves, or the particular assistance needed. Service user survey responses were generally positive, “Matron and the staff are only too willing to see to your every wish at a moment’s notice, or as soon as they can,” wrote one resident. Park House Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 12 Another resident said, “I don’t always get the help I need to go to the toilet quick enough, which sometimes upsets me.” Responses from relatives about the care received were all positive, with a number of cards and letters on display expressing satisfaction at the care given to their relatives. The lunchtime administration of medication for residents was observed and this was carried out in accordance with accepted policies and procedures, with records accurately signed and dated. None of the people case tracked wished to self-medicate, but procedures were in place to enable residents to do this. All the medication seen was stored correctly and within date. Staff were observed treating the residents with respect and dignity and responses written in the surveys from service users and relatives were all positive about this, “the staff and manager are always kind and respectful,” was one comment. Park House Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 13 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): 12, 13, 14, 15, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are helped to make choices and contact with family and friends is positively encouraged, but more attention to the organisation of activities would improve lifestyle and well-being. Food is appetising and served in pleasant surroundings. EVIDENCE: Staff spoken with said they had unsuccessfully tried group activities, like Bingo, “but they didn’t work.” So, they tended to carry out individual activities, such as playing dominos, or talking about a resident’s childhood. The residents said they enjoyed the singalongs, which were organised, but there weren’t many other regular activities. The service user survey responses contained 4 that said “there were never any activities organised I could join in.” The relative survey responses also contained some negative responses, “my relative needs more stimulation and much more physiotherapy.” Park House Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 14 “My relative is in bed most of the time and the staff are so busy they don’t get time to stop and talk.” Relative survey responses indicated they thought “the qualified staff were very busy, but it would be nice if they could spend some time with the patients who are not so unwell, to help reduce the negative effects of being alone.” The “activities book” was seen, with records of a list of those who used the hairdresser on the 30th April, that two people went out with relatives on the 3rd May and there was a Pampering day on the 4th May. There were no other entries until 18th May when a singalong was recorded, which reflects the lack of any regular, organised activities and interactions. A large writing pad and pen were supplied to a service user who had hearing difficulties and I was informed by the resident that staff spent time communicating through the paper and this was also evidenced by the number of previous written conversations on the pad, seen during our discussion. This resident said, “I appreciate the time spent helping me to be part of what’s going on.” All the meals are served in a pleasantly decorated and furnished dining area, with tea served in pots with cups and saucers, “adding a touch of class” as one resident said. Residents said the food was always good and choices were available. The lunchtime meal was observed, and all spoken with said they enjoyed the food. Some residents required pureed food and this was also observed and was set out on the plate in separate types, to enable the resident to experience the individual flavours. A birthday cake, with candles, and everyone singing “happy birthday” was presented after lunch to celebrate a resident’s birthday, and staff said a cake was always presented to make the day special for anyone with a birthday. The family of one service user said how much they appreciated this extra effort by the kitchen staff. Park House Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 15 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): 16, 18, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. All complaints are taken seriously and dealt with and procedures for safeguarding adults followed to provide security for the residents. EVIDENCE: Records of complaints showed they were all dealt with within 28 days, as set out in the home’s policy. Residents and relatives spoken with all said they would pass any complaints to the matron to deal with, as “she is very approachable and wants to do her best for my relative.” The service user and relative survey responses were all positive, answers included, “I’ve never needed to make a complaint.” Care staff, spoken with, were aware of their roles in safeguarding adults and trained staff spoken with were also aware of their roles in this procedure. Since the last inspection, there had been one anonymous concern, which was referred to the adult services, which was not upheld and has been resolved. Park House Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 16 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): 19, 20, 23, 24, 26, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home provides a safe, clean and pleasant environment, generally wellmaintained with private rooms which are personalised and suit the needs of the residents. EVIDENCE: The home is clean and pleasant, the dining area had added touches, like individual named place cards, teapots with teacups and saucers, which the residents say, “makes us feel just like home.” Residents’ own rooms were individualised, with their personal possessions in them, and all the service user and relative surveys returned were positive about the environment. Park House Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 17 Residents spoken with said they were very happy with the home’s environment and particularly their own rooms and relatives spoken with also said the new relatives room was a, “useful and quiet place to go.” Generally, records showed the maintenance of the home was dealt with promptly, however, the glass in the relatives room window was broken and the lock on the visitors toilet door was not working. The gardens around the home were well-kept and a fence was being erected at the side of the home for additional protection. Park House Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 18 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): 27, 28, 29, 30, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The number of staff on duty was sufficient to meet the needs of the residents, with appropriately recruited staff, who are trained to do their jobs. However, carers do not always follow the practices taught when moving some residents, which could cause discomfort. EVIDENCE: Staffing levels, identified on the duty rotas, were sufficient to meet the needs of the residents. The residents said there were usually enough staff on duty to help them when they needed it, but one said, “I don’t always get help when I need it to go to the toilet.” Responses in the surveys were all positive, and praised the staff, “My relative is very well looked after 24 hours a day.” Recruitment records were complete and contained all the information needed to show suitability to work in the home, including Criminal Records Bureau checks, professional references and evidence of identification. Park House Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 19 Staff spoken with said they received regular training in their roles. But, I observed staff moving residents from wheelchairs to armchairs, using outdated, underarm lifts, a practice which was also noted during the last inspection. Staff files contained certificates showing moving and handling training had been attended and National Vocational Qualifications undertaken by carers. Basic food hygiene and health and safety training records were also seen, but no evidence of training in first aid was seen in the files case tracked. A new training officer has been employed, responsible for induction of new carers and also for supporting carers undergoing National Vocational Qualification training. Having recently been employed, there was no input identified at the time of this inspection. Park House Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 20 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): 31, 33, 35, 36, 37, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Park House is well managed, with an open approachable management style, which supports residents and relatives. However, staff supervision needs to be improved to monitor the quality of care and support the learning needs of staff. EVIDENCE: Surveys were all positive about the management within the home, “Matron is always there for me to talk to about by relative,” “The home is run very well,” “Matron is only too happy to answer any of my questions,” were some of the written responses. Residents and relatives spoken with were also positive in their responses. Park House Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 21 “I only have to ask and matron sorts things out.” The only money residents have is for their own personal needs, but, records of residents’ finances were seen to be accurate and up to date, with all transactions receipted, signed and dated. Some staff files had records of appraisal in February 2007, but the only evidence of any supervision seen was a note made in one file that matron had observed the work of a carer. None of the files contained any reference to training needs, but some had copies of outdated first aid certificates. Staff spoken with said, “Matron watches what we do and I have had appraisal in February.” Another though said, “I have never had any appraisal, or supervision since I’ve worked here.” The pre-inspection questionnaire sent to the commission before the inspection visit, contained dates of the mandatory health and safety checks, including fire alarm testing, fire officer and environmental health officer visits. Records seen in the home supported this information was correct. Relatives and residents spoken with said they felt the home was run in their best interests. The “thank you” cards reflected this. Questionnaires, sent to residents and relatives regularly, monitor the quality of the service provided, they are collated by Mr. Day and passed to matron to deal with any issues brought to light. The last set of these questionnaires and responses were seen and issues brought to light had been dealt with. Park House Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 X X 3 3 x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 3 x Park House Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? yes 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(1) Requirement Timescale for action 30/08/07 2. OP12 16(2) 3 OP30 18(1) Care plans must set out in detail the actions to be taken by care staff to ensure all the resident’s needs are met, whilst encouraging and maintaining any abilities and independence the resident may still have to promote and support the wellbeing of residents in the home. Activities reflecting the interests 30/08/07 and preferences of the residents should be put into practice regularly to promote the physical and mental well-being of all residents Carers must receive training 30/08/07 including first aid and this must be maintained up to date to encourage a competent workforce to support the residents who need help. Regular supervision of staff must be undertaken and include the professional and personal development needs of the staff member to ensure carers are competent in their roles and to DS0000026460.V337547.R01.S.doc 4 OP36 18(2) 30/08/07 Park House Care Home Version 5.2 Page 24 provide evidence they are working in accordance with training undertaken. THIS WAS A REQUIREMENT SET AT THE PREVIOUS INSPECTION ON 08/05/06 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 OP19 Good Practice Recommendations Routine maintenance should be kept up to date and the lock to the visitors’ toilet door repaired and the glass in the window in the relatives’ room replaced to reduce the risks to people using the room. Park House Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Care Home DS0000026460.V337547.R01.S.doc Version 5.2 Page 26 - 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. 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