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

This inspection was carried out on 5th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 23/05/07

Park House Care Home 08/05/06

Park House Care Home 14/10/05

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 Susan Lewis Rob Cooper Unannounced 5th July 2005 at 10:15 am 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 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 C53 C03 S26460 Park House V236216 050705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Park House Care Home Address Cinderhill Road Bulwell Nottingham NG6 8BS 0115 9771363 0115 9771460 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Eastgate Limited Eunice Browne Care home with nursing 47 Category(ies) of OP Old age, x 47 registration, with number TI Terminally ill, x 2 of places Park House Care Home C53 C03 S26460 Park House V236216 050705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Within the total number of beds a maximum of 2 beds may be used for the category of TI Date of last inspection 24 March 2005 Brief Description of the Service: Park House is a purpose built care home with 47 places, offering residential and nursing care for 47 older people including two beds for those who are terminally ill. The home is situated in the Bulwell area of Nottingham and has access to bus routes and various community facilities. The building is on two floors with lift access to the first floor, all areas are wheelchair accessible with adaptations and equipment appropriate to the needs of the service users. The garden has several seating areas and a conservatory leading on to the garden. The home is owned and managed by Eastgate Ltd; the registered manager is a first level nurse with several years experience in care homes. Park House Care Home C53 C03 S26460 Park House V236216 050705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 5 hours and was carried out as part of the annual inspection process. A partial tour of the building took place and staff and care records were inspected. Three staff, eight residents and three visitors were spoken with. What the service does well: What has improved since the last inspection? What they could do better: The registered manager, although providing leadership for the staff, has failed to meet the requirements set at the last inspection regarding the plans of care and recruitment practices. The registered manager must ensure that where residents are admitted to the home that risk assessments take place promptly to minimise the risk to them and to staff. The registered person must continue with the programme of refurbishment and ensure that the areas identified as constituting a risk, the stairs and the visitors’ toilet, are repaired. The registered manager must ensure that all staff recruited have two references and a police check to ensure the safety of residents. Park House Care Home C53 C03 S26460 Park House V236216 050705 Stage 4.doc Version 1.40 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Park House Care Home C53 C03 S26460 Park House V236216 050705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Park House Care Home C53 C03 S26460 Park House V236216 050705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3, 4 and 6 Prospective residents have the information needed to make an informed decision, however the lack of completed plans of care places new residents at potential risk. Residents’ cultural needs are at risk of not being met. EVIDENCE: Intermediate care is not provided. A recommendation was left at the last inspection regarding the Statement of Purpose. It had recommended that the address of the Commission be included in the complaints procedure and not a named person. This has been met, however the registered person should remove the out of date page from the document. Four plans of care were inspected and all showed evidence that a preadmission assessment took place. In one plan not all forms were filled out, however, this resident was a new admission and the plan was still under construction. Some of this information was very important such as the person’s communication needs and risk assessments. There was little information regarding the person’s cultural needs and the Community Care Park House Care Home C53 C03 S26460 Park House V236216 050705 Stage 4.doc Version 1.40 Page 9 Assessment states one thing regarding food but this did not appear to be being carried out within the home. Park House Care Home C53 C03 S26460 Park House V236216 050705 Stage 4.doc Version 1.40 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 9 Some progress has been made on improving the information written in plans of care to ensure that the healthcare needs of residents are identified and met. However there are shortfalls in some identified plans, which have the potential to place residents at risk. EVIDENCE: At the last inspection a requirement was made for plans of care to reflect residents needs. Although some plans seen did reflect the needs of the resident, one plan in particular did not. The individual had been resident for three weeks and the plan was not fully completed leaving gaps in care that should have been identified from the Community Care Assessment, risk assessments had not been completed. This also had the potential to place staff at risk. It was also noted that the plans were hand written and very difficult to read therefore not in a style accessible to residents. Some plans were reviewed intermittently and there was no evidence that residents were involved in their creation or review. One care plan viewed had a nutritional risk assessment tool that identified the person as high risk and said to ‘review weekly’; no review had taken place since February 2005. Some residents spoken with were aware that they had plans of care and staff spoken with confirmed that they were encouraged to read them and familiarise themselves with residents’ needs. Park House Care Home C53 C03 S26460 Park House V236216 050705 Stage 4.doc Version 1.40 Page 11 Other plans of care assessed showed how residents’ needs were to be met including pressure care and continence management. In these instances the information provided was of a good standard. A visiting district nurse was spoken with and she commented positively on the care residents’ received and the professional manner of staff and management. Evidence was seen that GP visits were recorded and action was noted and taken according to instructions. Staff spoken with confirmed that equipment was available for residents with pressure care needs. Residents spoken with were positive about the care that they received and that staff would contact their GP if they felt unwell. Staff were observed administering medication and this was done with care and attention, records were up to date. The Pharmacist has recently visited to carry out their checks and there were no issues raised from this visit. At the last inspection a requirement was made to create a policy to include reporting of errors and keeping medication for seven days following the death of a resident. This has not been met. Park House Care Home C53 C03 S26460 Park House V236216 050705 Stage 4.doc Version 1.40 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15 Residents are able to spend their time as they choose and are provided with appetising and nutritious meals at times convenient to them. EVIDENCE: A requirement was set at the last inspection that activities should be provided to meet the needs of the residents. On the day of the inspection residents and visitors spoken with were happy with the level of activity provided by the home. The list of activities provided is placed on a notice board however it was difficult to find as other letters and information hid it. Residents spoken with were happy with how they spent their day and they could choose when and where they ate their meal. The midday meal was observed and it appeared appetising and nutritious. Staff were seen assisting residents in a sensitive manner and various aids were used to enable residents to feed themselves thereby remaining independent. Residents spoken with were positive about the quality and quantity of the food provided. The cook was spoken with and she was knowledgeable about residents’ dietary needs. On the day of the inspection an order of meat and fresh fruit and vegetables had arrived, the store cupboard was well stocked. Park House Care Home C53 C03 S26460 Park House V236216 050705 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Residents are confident that complaints will be dealt with and residents are protected from abuse. EVIDENCE: All residents and visitor spoken with knew who to complain to if they needed to and all felt that it would be taken seriously and dealt with. Although staff spoken with said they had not had any formal Adult Abuse Awareness training the manager regularly discussed it in team meetings and would bring articles in that referred to abuse in adult care settings. Staff had a good understanding of what constituted abuse and what to do if they suspected it. Staff were aware of the whistle blowing policy and the home has a copy of the Nottinghamshire County Council Protection of Vulnerable Adults Procedures. A requirement was set at the last inspection regarding recruitment and selection this requirement will be dealt with under standard 29. Park House Care Home C53 C03 S26460 Park House V236216 050705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 Improvements are being made to the décor and the environment, with the exception of the stairs and the visitor’s toilet, is safe and comfortable. EVIDENCE: A programme of redecoration is currently taking place within the home and evidence for this was seen in a number of bedrooms. Residents spoken with said that they liked their rooms and one resident said that they had been able to move bedrooms to a slightly larger one to accommodate personal possessions. Visitors spoken with said they thought the accommodation was good and very clean. It was noted on the stairs to the front of the building that the floor covering was lifting away from the stairs, as this could be a trip hazard this must be repaired. The Altro flooring in the visitors toilet is also lifting at the edges and is a potential infection hazard. On the day of the inspection the home was clean and free from odour residents spoken with confirmed that their clothes were laundered and they were happy with the standard. Park House Care Home C53 C03 S26460 Park House V236216 050705 Stage 4.doc Version 1.40 Page 15 Park House Care Home C53 C03 S26460 Park House V236216 050705 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 and 30 Recruitment practices within the home are not robust and have the potential for placing residents at risk. Staff receive training to ensure they are competent to do their jobs. EVIDENCE: Staff files were inspected and a number were found not to have references and Criminal Records Bureau checks and photographic evidence of identification. The registered person must ensure that a robust and thorough recruitment practice is followed. A number of staff that have worked at the home for a number of years do not have two references and predate the Care Standards Act 2000. Where this is the case the registered manager must make arrangements for suitable character references to be available on file. The requirement made at the last inspection under standard 18 regarding robust recruitment practices is not met. The requirement will now be made under standard 29. Staff spoken with had all worked at the home for a number of years and were positive about their experience. They receive in-house training as well as attending external courses. All staff spoken with confirmed that they had regularly up dated mandatory training as well as induction training which included shadowing fellow workers until they felt confident in their role. Park House Care Home C53 C03 S26460 Park House V236216 050705 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 38 The home is well managed with a clear sense of direction, residents’ and staff is promoted and protected. EVIDENCE: Staff and residents spoken with were positive about the management style of the registered manager and staff said that she gave a clear sense of direction about the standard of care that she expected them to deliver. The requirement set at the last inspection regarding the carpet on the first floor as a trip hazard has now been met with carpet being secured. A second requirement was made regarding risk assessments for bedrails this has now been met. The maintenance records were seen and the home has recently had the Environmental Health Officer visit requirements were set and all but one is met. Staff confirmed that regular fire drills take place. Residents spoken with said that they felt their safety was taken seriously and they did feel safe. Park House Care Home C53 C03 S26460 Park House V236216 050705 Stage 4.doc Version 1.40 Page 18 Park House Care Home C53 C03 S26460 Park House V236216 050705 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 2 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x 3 x x x x x 3 Park House Care Home C53 C03 S26460 Park House V236216 050705 Stage 4.doc Version 1.40 Page 20 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 3 Regulation 14 Requirement The registered person unless impracticable to do so after consultation prepare a written plan as to how the service users needs in respect of of his health and welfare are to be met. Assessments are carried out for all residents entering the home and the care plan is based on the Care Management assessment. The registered person shall unless impracticable to carry out such consultation, shall after consultation with residents, or his representative prepare a written plan as to how the resident needs in respect of his health and welfare are to be met. The residents plan should set out in detail what action is to be taken. The registered person shall keep the residents plan under regular review. The registered person shall make suitable arrangements to ensure that the care home is conducted in a manner with due regard to the cultural needs of the resident. The registered person shall C53 C03 S26460 Park House V236216 050705 Stage 4.doc Timescale for action 1/08/05 2. 7 15 Immediate 3. 4. 7 4 15 4 1/09/05 1/09/05 5. 19 13 1/09/05 Page 21 Park House Care Home Version 1.40 6. 29 Sch 2, 7,9,19 ensure that all parts of the home that residents have access are so far as possible free from hazards to safety. The floor in the visitors toilet must be repaired and the floor covering on the stair treads must be repaired. The registered person must Immediate ensure that two written references are obtained before appointment and staff are only confirmed in post following completion of satisfactory police checks. 7. 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. 2. 3. Refer to Standard 9 7 7 Good Practice Recommendations The registered person should ensure that a suitable policy is available for the disposal of medication following the death of a resident. The registered person should ensure that care plans are written in a style accessible to residents. Where plans are hand written they should be legible. The registered person should ensure care plans are reviewed at least monthly. Park House Care Home C53 C03 S26460 Park House V236216 050705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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