Inspection on 13/12/05 for Park House, Little Knowle

This inspection was carried out on 13th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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, Little Knowle 04/03/10

Park House, Little Knowle 11/03/08

Park House, Little Knowle 19/05/06

Park House, Little Knowle 12/05/05

Park House, Little Knowle 23/11/04

Park House, Little Knowle 27/07/04

Similar services:

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

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

CARE HOMES FOR OLDER PEOPLE Park House, Little Knowle 11 Park Lane Little Knowle Budleigh Salterton Devon EX9 6QT Lead Inspector Michelle Oliver Unannounced Inspection 12:15 13 December 2005 th 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, Little Knowle DS0000022001.V252983.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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, Little Knowle DS0000022001.V252983.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Park House, Little Knowle Address 11 Park Lane Little Knowle Budleigh Salterton Devon EX9 6QT 01395 443303 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) Mrs Mabel Eileen Lily Perry Mrs Suzanne Lily Mary Pilkington Mrs Mabel Eileen Lily Perry Care Home 27 Category(ies) of Dementia - over 65 years of age (27), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (27), Old age, not falling within any other category (27), Physical disability over 65 years of age (27) Park House, Little Knowle DS0000022001.V252983.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th May 2005 Brief Description of the Service: Park House is a large detached property situated in a large garden approximately half a mile from Budleigh Salterton town centre. Bedroom accommodation is provided on the ground and first floors. The first floor bedrooms can be reached by a chair lift.The home provides personal care for up to 27 older people who may have physical needs or dementia. Park House, Little Knowle DS0000022001.V252983.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 4 hours on Tuesday 13th December 2005. A senior carer was present during the inspection. Some residents and members of staff on duty also took part in the inspection. The inspector looked around the home. A number of records were inspected, which included staff files, care plans, fire logbook and record of accidents. What the service does well: What has improved since the last inspection? 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. Park House, Little Knowle DS0000022001.V252983.R01.S.doc Version 5.0 Page 6 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, Little Knowle DS0000022001.V252983.R01.S.doc Version 5.0 Page 7 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 the following standard(s): None of these standards were assessed at this visit. EVIDENCE: Park House, Little Knowle DS0000022001.V252983.R01.S.doc Version 5.0 Page 8 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 the following standard(s): OP7 Shortfalls in health care arrangements for residents have a potential to place them at risk. EVIDENCE: Individual plans of care are available for the majority of residents. Progress has not been made to ensure that information relating to all aspects of health, personal and social care needs are identified, up to date and made available to care staff. Plans remain basic, are not up to date and in one case no plan of care has been written for a resident who has moved to the home recently. Significant events relating to a residents’ health needs had been recorded but no information was available as to how staff would meet these needs. For example, no record had been made of the action taken by staff when a resident had, what was recorded as “ a fit”. No plans had been implemented to involve appropriate health care professionals, risks were not assessed and details of care to be given in the event of another incident had not been recorded. Another entry described aggressive violent outbursts to other residents and staff. No measures were in place to manage this situation. This potentially puts other residents at the home at risk of harm. Discussion with staff suggested that some needs were being addressed even though there was a lack of clear plans and guidance. This approach is dependent on staff Park House, Little Knowle DS0000022001.V252983.R01.S.doc Version 5.0 Page 9 memory and good verbal communication systems. Residents are at risk of not having their health care needs met if these informal systems break down. Following the inspection an immediate requirement was issued in relation to care planning and a letter sent highlighting concerns. The Commission is awaiting a satisfactory response from the provider stating the action taken to achieve compliance. Park House, Little Knowle DS0000022001.V252983.R01.S.doc Version 5.0 Page 10 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 the following standard(s): OP14 The rights of residents are recognised and respected within the home. EVIDENCE: Residents’ rooms are comfortable and many have been personalised with items such as furniture, pictures or ornaments that they are encouraged to bring to the home with them. Details of how to contact an advocate are available to residents or relatives if requested or indicated. Residents are encouraged to maintain their independence in whatever way or manner is meaningful to them. Park House, Little Knowle DS0000022001.V252983.R01.S.doc Version 5.0 Page 11 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 the following standard(s): Op18 Staff are aware of the procedures to follow to protect residents from abuse. EVIDENCE: Staff are aware of who to speak to in the event of an allegation of abuse. Not all staff have received training in the Protection of Vulnerable Adults. Staff said they had never seen any signs of abuse or poor practice in the home. Park House, Little Knowle DS0000022001.V252983.R01.S.doc Version 5.0 Page 12 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 the following standard(s): Op19. Park House provides a generally comfortable environment that promotes resident’s independence. Procedures are not in place to ensure that a safe environment is maintained. EVIDENCE: Park House is comfortable and homely. Residents and visitors said that the home is open and welcoming. The home employs a maintenance person on a part time basis and there is evidence throughout the home that it is generally well maintained but no record is kept of this. All areas are well laid out and accessible to residents who were seen moving freely around the home. Cleaning materials were stored in an unlocked downstairs bathroom at the time of this visit. This practice puts residents at potential risk from substances that could be harmful to their health and safety. Park House, Little Knowle DS0000022001.V252983.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Op29 & 30. The procedures for the recruitment of staff are not robust and do not provide the safeguards to offer protection to people living in the home. Resident’s benefit from having friendly staff that have an understanding of their needs. The provision of induction and foundation training is inconsistent. EVIDENCE: The files of two recently employed staff members were looked at. One included all the required documentation; no police check, references or proof of identity had been obtained for the other. No records were available for another member of staff who said she was working at the home “on trial” as an “ extra pair of hands”. She had no experience of working with older people and said she was not giving personal care to residents. She said that she had not had a recent police check. There was no evidence of two care staff receiving induction training within 6 weeks of being employed at the home. This potentially puts residents at risk of being cared for by staff that have not been trained on the principles of care, safe working practices and the experiences and particular needs of the resident group. The senior carer intends to introduce an Induction Progress Log of Standards for all staff when taking up employment at the home. Following the inspection an immediate requirement was issued in relation to recruitment procedures and a letter sent highlighting concerns. The Park House, Little Knowle DS0000022001.V252983.R01.S.doc Version 5.0 Page 14 Commission is awaiting a satisfactory response from the provider stating the action taken to achieve compliance. Park House, Little Knowle DS0000022001.V252983.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 33, 35 & 38. Resident’s financial interests are safeguarded. Some practices at the home do not promote and safeguard the health, safety and welfare of residents living at the home. EVIDENCE: Residents spoken to said they liked living at the home. However, systems for seeking and acting upon residents views, ensuring that they have a say in the running of the home are not in place. Residents’ finances are not handled at the home, accounts for services such as hairdressing, paper and chiropody are sent to residents or their representatives monthly. A number of fire doors were wedged open. Records showed that fire drills and instruction takes place. A fire door leading to a resident’s room has had a glass panel replaced by plywood at the time of the visit. A ground floor bathroom Park House, Little Knowle DS0000022001.V252983.R01.S.doc Version 5.0 Page 16 was being used to store cleaning chemicals that were easily accessible to residents, putting them at risk. Comprehensive risk assessments relating to health care and safety issues have not been completed for all residents. Following the inspection an immediate requirement was issued in relation to health and safety and a letter sent highlighting concerns. The Commission is awaiting a satisfactory response from the provider stating the action taken to achieve compliance. Park House, Little Knowle DS0000022001.V252983.R01.S.doc Version 5.0 Page 17 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 1 2 X X X X X X X STAFFING Standard No Score 27 X 28 X 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 1 X 3 X X 1 Park House, Little Knowle DS0000022001.V252983.R01.S.doc Version 5.0 Page 18 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 OP7 Regulation 15 [1] Requirement The registered person shall after consultation with the service user, or a representative of his, prepare a written plan [the service user’s plan] as to how the service user’s needs in respect of his health and welfare are to be met. The registered person shall make arrangements by training staff or by other measures to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. The registered person shall not employ a person to work at the care home unless he has obtained for that person the information and documents specified in paragraphs 1 to 7 of Schedule 2 The registered person shall ensure that at all time suitably qualified persons are working at the care home as are appropriate for the health and welfare of service users. [This relates to ensuring that all staff receive induction training DS0000022001.V252983.R01.S.doc Timescale for action 10/01/06 2. OP18 13[6] 10/02/05 3. OP29 19[1][b] 10/01/06 4. OP30 18[1][a] 28/01/06 Park House, Little Knowle Version 5.0 Page 19 5. OP33 24[1][a][ b] 6. OP38 23[4][c][ 1] 7. OP38 13[4][a] 8. OP38 13[4][c] within 6 weeks of appointment to their posts.] The registered person shall establish and maintain a system for reviewing at appropriate intervals and improving the quality of care provided at the care home. The registered person shall make adequate arrangements for containing fires. [This relates to ensuring that all fire doors are able to close freely in the event of the fire alarm sounding] The registered person shall ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety. [This relates to cleaning materials being stored in an unlocked room easily accessible to residents] The registered person shall ensure that unnecessary risks to the health or safety of service users are identified and as far as possible eliminated. 28/02/06 10/01/06 11/01/06 11/01/06 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 A programme of routine maintenance and renewal of the fabric and decoration of the home is produced and implemented with records kept. Park House, Little Knowle DS0000022001.V252983.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Park House, Little Knowle DS0000022001.V252983.R01.S.doc Version 5.0 Page 21 - 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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