Inspection on 14/12/05 for Park House Nursing Home

This inspection was carried out on 14th December 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 Nursing Home 29/04/08

Park House Nursing Home 20/07/07

Park House Nursing Home 23/08/06

Park House Nursing Home 22/06/05

Park House Nursing Home 18/11/04

Park House Nursing Home 22/07/04

Park House Nursing Home 05/02/04

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Park House Nursing Home Park Lane Queensbury Bradford BD13 1QJ Lead Inspector Mary Bentley Unannounced Inspection 14th December 2005 09:30 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 Nursing Home DS0000029237.V273334.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 Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Park House Nursing Home Address Park Lane Queensbury Bradford BD13 1QJ 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) 01274 817014 01274 818288 Kloriann Medicare Ltd Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25), Physical disability (1), Terminally ill over of places 65 years of age (3) Park House Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The place for PD is specifically for the service user named in the application for variation dated 20 May 2005 22nd June 2005 Date of last inspection Brief Description of the Service: Park House is a converted Victorian house set in its own grounds and situated near the village of Queensbury. The home has well maintained gardens that include a woodland walk, and are accessible to service users. There is wheelchair access to a patio area from one of the lounges. The home offers nursing care to male and female service users over the age of 65 and provides three places for the care of people with terminal illnesses. Park House provides accommodation in eight double and nine single rooms, eleven of these rooms have en-suite toilets. Many of the rooms in the old part of the house have excellent views of the gardens. The home has 2 lounges, a dining room, conservatory and a small seating area on the second floor. The standard of décor is good. The home has a no smoking policy. Park House Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Over an inspection year, from April until March, care homes have a minimum of two inspections; these may be announced or unannounced. This was the second unannounced inspection of this home; the first inspection was also unannounced and took place in June 2005. There have been no further visits to the home until this unannounced inspection. One inspector carried out the inspection between 9.30am and 4.00pm, before the visit time was spent planning the day. The home recently appointed a new manager and the purpose of this visit was to assess how she was settling into her role and to assess the impact of the management change on the services provided. The inspection also looked at the progress had been made on meeting the requirements from the last visit. The methods used in this inspection included discussions with residents, relatives, staff and management, examination of records, and a partial tour of the home. The home prefers the term “resident” to “service user” therefore that is the term that will be used throughout this report. Comment cards were left at the home for residents and relatives; these cards provide an opportunity for people to share their views of the service with the CSCI. Comments received in this way are discussed with the provider without revealing the identity of those completing them. What the service does well: All parts of the home are decorated and furnished to a high standard providing a pleasant, clean and comfortable environment for residents. Some visitors commented on the high standard of décor, they were impressed by the attention to detail and the homely environment that has been created at Park House. It was evident that the home had gone to a lot of trouble to make sure that the home was nicely decorated for the festive season. One visitor said it was a lovely place and she had peace of mind knowing her relative was being cared for there. Residents and relatives felt they were consulted about care needs and relatives said they were kept informed of changes in their relatives’ conditions. Residents and relatives said staff were kind and approachable. Privacy and dignity are respected and visitors said they always feel welcome. Prospective residents and/or their representatives are encouraged to visit before making a decision about admission and trial periods are offered. Residents and relatives said the food was good. Park House Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 Page 6 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 Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 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 Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 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 the following standard(s): 1,3,4 & 5. Standard 6 does not apply to this service. Relatives said they had been given enough information to make an informed decision. However the shortfalls in the Statement of Purpose create the opportunity for future residents and/or their representatives to feel they have not been fully informed. Prospective residents and/or their representatives are given the opportunity to visit the home before admission and residents are not admitted until their needs have been assessed. EVIDENCE: An information pack is available to be given to all prospective residents; this includes a brochure, Statement of Purpose, Service User Guide and a copy of the Terms and Conditions of residency. However the Statement of Purpose does not include information on the room sizes and has not been updated to reflect changes to the category of registration. The files looked at contained completed pre-admission assessments, they were detailed and included information on where the assessment had been done and who had been involved. One set of records showed that admission had been Park House Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 Page 9 agreed for a trial period to establish whether or not the home could meet the resident’s needs. Relatives spoken with confirmed they had been able to visit the home before admission and said they had been given all the information they needed during this visit. One relative was particularly pleased that it had not been necessary to make an appointment for the pre-admission visit. Park House Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 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 the following standard(s): 7, 8 & 9 Overall residents’ personal and health care needs are met. The work on improving the care records must continue in order to minimise the risk of care needs being overlooked. Residents are protected by the homes policies and procedures for dealing with medicines. EVIDENCE: A lot of work has been done on the care records, they are more organised and it is easier to find information. The plans seen had been reviewed monthly. There was some evidence of involvement by residents and/or their representatives and the new manager has identified this as an area to be developed further. The plans address how personal, health and social care needs will be met however some improvements are needed to make sure that they fully reflect individual needs and preferences. The format used for care records does not show when the assessments of individuals needs have been reviewed and/or updated. Park House Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 Page 11 There were risk assessments in place relating to the risk of developing pressure sores, falls, nutrition, moving and handling and the use of bed rails. Where risks had been identified the appropriate care plans were in place. The risk assessment relating to bed rails does not set out clearly the reasons for the decision to use bed rails. The manager had identified that the nutritional risk assessment was not detailed enough, she has arranged for training on a more comprehensive risk assessment tool to take place in January. Training has also been arranged on the prevention of falls and this will include an update of how a falls risk assessments should be completed. The home has nominated a tissue viability link nurse to work with the community Tissue Viability nurse specialist. The home is hoping to take part in the “First Dressings Initiative”; this is a scheme run by the Tissue Viability nurse specialist. The aim of the scheme is to improve the initial treatment of wounds and pressure sores in care homes in the area. The files showed that residents in the home have access to a range of community health and social care professionals as needed. Overall residents and relatives were satisfied that their personal and health care needs were met, one visitor said residents should be able to have a bath more than once a week. A new medication system is being introduced in January 2006; nursing staff will be training on how to use it before it is implemented. An additional cupboard has been provided for the storage of controlled drugs. Alternative arrangements for the disposal of medicines have been made to comply with recent changes in the law. No residents were administering their own medicines at the time of the visit; the manager said she was aware of the need for risk assessments to be done if residents wanted to self medicate. Park House Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 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 the following standard(s): 12, 13 & 14 More attention should be given to providing residents with regular opportunities to take part in social and leisure activities that reflect their preferences and expectations. Residents are supported in keeping in contact with family, friends and the local community as they wish. EVIDENCE: The activities organiser was on leave at the time of the inspection. The home had their Christmas party last week and a Carol service was planned. Entertainers visit the home regularly and there are some planned activities for residents although recently these seem to have been less frequent. Some relatives said they would like to see more going on. The manager is planning a residents meeting in January to discuss, among other things, the provision of social and leisure activities. The personal histories seen in some files provide a great deal of information about individual residents past lives, interests and hobbies. It would be good Park House Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 Page 13 to see this information being used to develop a more individualised approach to the programme of activities. Residents are encouraged to exercise choice in their daily lives and are consulted about such things as times for getting up and going to bed, what clothes to wear and where to spend their time. There are no restrictions on visiting and relatives said they feel welcome in the home at any time. It was evident that visits can take place in private. Some relatives go out with family and/or friends and a number of residents had plans to spend Christmas day away from the home with their families. Park House Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 Page 14 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): 16, 18 The home has the required policies and procedures in place to make sure that complaints are dealt with appropriately and that residents are protected from abuse. EVIDENCE: A complaints procedure is available. Relatives and residents were aware of how to raise any concerns they might have. The Adult Protection procedures are available in the home. Progress is being made on providing all staff with Adult Protection training. Some staff have already attended this training and the remaining staff are waiting for confirmation of training dates. Park House Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 Page 15 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): 19, 21 & 26 Residents live in a pleasant, comfortable, safe and well-maintained environment. EVIDENCE: All parts of the home were clean and well maintained. One visitor said the bedroom was perfectly suited to her relatives needs and others said that the home is always clean and free of unpleasant smells. The home has two assisted bathrooms; this falls short of the National Minimum Standards that recommend a ratio of 1 to 8. The home has the required policies and procedures and equipment to reduce the risk of cross infection. Two staff were doing infection control training. Park House Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 There are not always enough staff to meet residents need in a timely manner. A training plan has been put in place to make sure that staff have the knowledge and skills to meet residents needs. The manager is reviewing the homes recruitment procedures to make sure that they are robust enough to protect residents. EVIDENCE: Duty rosters are available for all grades of staff. There are usually five staff on the morning shift, (one nurse and four care assistants) and four on the afternoon shift (one nurse and three care assistants). The home also employs housekeeping and laundry staff, kitchen staff and a part time handyman. Some relatives said the home is sometimes short staffed in the afternoon with only two care assistants on duty and when this happens residents have to wait for staff assistance. Six care staff are qualified to National Vocational Qualification (NVQ) level 2 or above, this equates to 43 of the care staff employed at Park House. The National Minimum Standards recommend that 50 of care staff are qualified to this level by December 2005. The new manager has carried out an audit of the staff files and identified where there are shortfalls in the records. Most of the shortfalls relate to proof Park House Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 Page 17 of eligibility to work in the United Kingdom and at the time of the inspection she was dealing with it. During previous inspections concerns have been raised about the lack of staff training and training records. The new manager has started to address this by putting a three-month training plan in place. A number of training sessions have been arranged for January 2006, these will include training on the new medication system, falls prevention and nutritional assessments. Further training needs will be identified through the programme of staff appraisals that is due to start in January 2006. A moving & handling co-ordinator has been nominated; she has attended a five-day training course and will be responsible for providing moving & handling training to all staff. Another member of staff is booked to attend fire training with West Yorkshire Fire & Rescue Services in January 2006; this will enable her to provide fire training to all the staff. The manager is developing individual training records for all staff. Park House Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 The new manager has the relevant qualifications and experience for the role and is fully aware of her responsibilities. There are no quality assurance/monitoring systems in place. Residents’ financial interests are safeguarded. EVIDENCE: The manager is a registered nurse and has completed a management training course that is the equivalent to NVQ (National Vocational Qualification) level 4. The law requires managers of care homes to be registered with the CSCI and at the time of the inspection her application to be registered was being processed. Park House Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 Page 19 There are no formal quality assurance systems in place and no systematic approach to seeking the views of residents, relatives and other stakeholders. Informal consultation takes place with individual residents and their relatives but the information obtained in this way is not used to measure the overall performance of the home against its stated aims and objectives. The home acts as appointee for two residents, this is a long-standing arrangement and came about because of exceptional circumstances. The home no longer takes on the responsibility for managing residents finances. Neither of these residents receives a personal allowance and any additional services they require, such as hairdressing, are paid for by the home. For the remaining residents the home issues invoices for the fees and for additional services such as hairdressing and/or newspapers. None of the residents in the home manage their own finances. The new manager has devised a programme for staff appraisals and supervision and this is due to start in January 2006. Accident records should be kept in individual residents files to comply with Data Protection law. As stated in the Staffing section of this report action is being taken to make sure that all staff receive training in moving & handling and fire safety at the required intervals from an appropriately trained person. A more detailed risk assessment is needed for the use of bed rails. Park House Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 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 2 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X 2 X X X X 3 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 2 X 2 Park House Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 Page 21 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 OP1 Regulation 4 Sch.1 Requirement The Statement of Purpose must include details of the number and sizes of rooms in the home. Previous timescales of 29/10/04, 25/02/05 & 31/08/05 not met. The Statement of Purpose must be updated to reflect the changes made to the registration categories of the home and a copy must be sent to the CSCI. Previous timescale of 31/08/05 not met. Care plans must provide evidence of consultation with residents and/or their representatives. Previous timescale of 29/10/04, 25/02/05 & 28/09/05 not met. The assessment of residents needs must be reviewed and updated to reflect changes in circumstances. Timescale for action 31/03/06 2. OP1 4 31/03/06 3. OP7 15 31/03/06 4 OP7 14 31/03/06 Park House Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 Page 22 5 OP18 13(6) Progress must be maintained on providing all staff with training on adult protection procedures and issues relating to abuse. Carried forward from the last inspection. The registered persons must make sure that there are enough baths/showers to meet the needs of residents. Previous timescales of 25/03/05 & 26/10/05 not met. The registered persons must make sure that there are enough staff to meet residents needs at all times. The registered persons must make sure that all preemployment checks are completed before new staff start work in the home. Previous timescale of 16/12/04 & 31/08/05 not met. The registered persons must make sure that all the required records are available for staff employed in the home. Staff must be given suitable help to develop their knowledge and skills and to achieve further qualifications. Carried forward from the last inspection. A system to monitor the quality of the service provided which actively seeks input and feedback from residents; relatives and other people involved with the home must be put in place and the findings made available to service users. DS0000029237.V273334.R01.S.doc 31/03/06 6 OP21 23(2)(j) 31/03/06 7 OP27 18 31/03/06 8 OP29 19 31/03/06 9 OP29 19 31/03/06 10 OP30 18 31/03/06 11 OP33 24 30/06/06 Park House Nursing Home Version 5.0 Page 23 12 OP36 18 Previous timescales of 29/11/04, 25/02/05 and 26/10/05 not met. Care staff must have formal supervision at least six times a year. Previous timescales of 29/10/04, 25/02/05 & 28/09/05 not met. All staff must have moving and handling training at least once a year. All staff must have fire training at least twice in every 12 months. Previous timescales of 29/10/04, 16/12/04 and 31/08/05 not met. A more detailed risk assessment must be carried out for the use of bed rails. 31/03/06 13 OP38 13(5) & 23(4) & 18 31/03/06 14 OP38 13(7) 31/03/06 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 2 Refer to Standard OP7 OP12 Good Practice Recommendations The home should, within reason, be able to comply with residents’ wishes with regard to how often they have a bath. The programme of activities should reflect the interests, preferences and expectations of residents. Consideration should be given to providing communal daily newspapers for residents. 50 of care staff should be qualified to NVQ level 2 or equivalent It is recommended that the home involve an independent DS0000029237.V273334.R01.S.doc Version 5.0 Page 24 3 4. OP28 OP35 Park House Nursing Home 5 OP38 advocate for those service users whose financial affairs are managed by the home. Carried forward from the last inspection. Accident record should be stored in individuals’ files to comply with Data Protection law. Park House Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Nursing Home DS0000029237.V273334.R01.S.doc Version 5.0 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. 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