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Inspection on 21/11/05 for Park House Nursing Home

Also see our care home review for Park House Nursing Home for more information

This inspection was carried out on 21st November 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Assessments were carried out satisfactorily. Feedback from service users, visitors and staff during the inspection was very positive. Service users stated that their privacy and dignity was respected, and that the food was nice. They added that they are afforded choices. Care plans and health care assessments were generally recorded to an acceptable standard. The provision of activities is satisfactory. The premises is fit for purpose, and was clean and tidy at the time of the inspection.

What has improved since the last inspection?

Service users have been issued with contracts. Some aspects of medication management have improved. The statement of purpose now contains al of the required information. The inspector was advised that all staff have Criminal Records Bureau Checks, and statutory training is up to date.

What the care home could do better:

Records relating to pressure area care should be maintained consistently. Some areas of medication management require improvement. Bathrooms used as storage areas should not be accessible to service users or visitors to avoid the risk of trips and falls. Policies should be updated at least annually. Risk assessments should be written where risks are identified. The fire officers advice should be sought in relation to the bedroom doors, and absence of automatic closures.

CARE HOMES FOR OLDER PEOPLE Park House Nursing Home 50 Park Road Wellingborough Northants NN8 4QE Lead Inspector Mrs Sarah Smart Unannounced Inspection 21st November 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 DS0000012631.V268060.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 DS0000012631.V268060.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Park House Nursing Home Address 50 Park Road Wellingborough Northants NN8 4QE 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) (01933) 443883 (01933) 279844 Four Seasons Homes No 4 Limited Mrs Pamela Mary Band Care Home 42 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (42), of places Physical disability over 65 years of age (10), Terminally ill over 65 years of age (42) Park House Nursing Home DS0000012631.V268060.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. No one falling within the category OP may be admitted into the home where there are 42 service users of this category already accommodated within the home No one falling within the category PD(E) may be admitted into the home where there are 10 service users of this category already accommodated within the home No one falling within the category DE(E) may be admitted into the home where there are 6 service users of this category already accommodated within the home No one faling within the category TI(E) may be admitted into the home where there are 42 service users of this category already accommodated within the home To be able to admit the named person in variation application dated 20th May 2004 number V000014766 28th April 2005 2. 3. 4. 5. Date of last inspection Brief Description of the Service: Park House is situated close to Wellingborough town centre. It is a purpose built home located in a residential area of the town. All the rooms are single rooms with ensuite facilities, although two rooms are currently used as double rooms, with the second room used as a sitting room. The home is laid out over two floors with a small outside area which is accessible to service users. Park House Nursing Home DS0000012631.V268060.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was undertaken between the hours of 9.30 and 13.50. Preparation for the inspection included, review of the previous inspection report, and requirements and recommendations, and took approximately 1 hour. The primary method of inspection used was ‘case tracking’. This involves selecting a number of service users and tracking their care and experiences through review of their records, discussion with them, the care staff and observation of care practices. The following areas were covered during the inspection: case tracking, medication, sample of policy review, staff rota, provision of activities, a tour of the premises, previous requirements made, and staff and service user interviews. Two service users were case tracked. Two staff members, plus the manager, were interviewed at length, and several others briefly, whilst three service users and a visitor were spoken to in detail. What the service does well: What has improved since the last inspection? Service users have been issued with contracts. Some aspects of medication management have improved. The statement of purpose now contains al of the required information. The inspector was advised that all staff have Criminal Records Bureau Checks, and statutory training is up to date. Park House Nursing Home DS0000012631.V268060.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Park House Nursing Home DS0000012631.V268060.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 DS0000012631.V268060.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): 2,3,4,6 Service users are able to make an informed choice about the home, knowing that their needs will be met. EVIDENCE: The inspector noted, and was advised that all service users have now been issued with contracts of residency. The service users files viewed contained thorough assessments from which the care needs are identified. Several service users were spoken to by the inspector, plus a visitor. All of those spoken to gave positive feedback, and stated that their needs were being met. Intermediate care is not provided. Park House Nursing Home DS0000012631.V268060.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Service users health and personal care needs are met. Medication recording should be improved. EVIDENCE: One of the service users case tracked resided on the nursing floor. This service users care plans were generally written to a high standard, but in one instance did not correspond with the information on the nutritional score in relation to the grade of the service users pressure sore. The second service user resided on the ground floor, and was receiving personal care. This service users care plans were written to a very high standard. Neither of the care plans viewed were signed by the service user or their representative, however the manager stated that the majority of care plans are now signed appropriately. Healthcare assessments were in place and completed accurately in every instance, other than that mentioned above. Identified action was noted to have been taken. All but one such assessment had been reviewed timely. One service user who was being nursed in bed did not have a turn chart in use. The nurse was asked how regular pressure area care was maintained. She Park House Nursing Home DS0000012631.V268060.R01.S.doc Version 5.0 Page 10 stated that turn charts were not used. The manager stated that this was incorrect, and that turn charts are usually used within the home. There was no evidence that the service user was not being turned appropriately. Medication was viewed on both floors. On the ground floor the management of medication was satisfactory. On the nursing floor variable doses were not being recorded. This was the subject of a previous requirement. A dressing being used on a service users wound was not prescribed for that service user. Staff were not recording a service users pulse before administering digoxin, although the nurse in charge demonstrated that she recognised the need for doing this. The recording associated with controlled drugs was satisfactory. Service users spoken to by the inspector stated that their privacy and dignity is protected and respected at all times. Park House Nursing Home DS0000012631.V268060.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Activities are provided adequately. EVIDENCE: Service users advised the inspector that there are plenty of activities in the home. Records indicated that service users interests and social history is recorded. At the time of the inspection a church service was being held in the home, and a collection of owls were being displayed to a large group of service users by their owner. A service user and her visitor were spoken to. Both stated that they were happy with the care at the home. Service users advised that they are afforded choices regarding their lives at the home. One service user said that she prefers to stay in her room, and that staff respect this. Service users stated that the food is nice, and that they have a choice. Park House Nursing Home DS0000012631.V268060.R01.S.doc Version 5.0 Page 12 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): These standards were not assessed at this inspection. EVIDENCE: These standards were not assessed at this inspection. Park House Nursing Home DS0000012631.V268060.R01.S.doc Version 5.0 Page 13 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): 19,20,21,22,23,24,25,26 The premises is satisfactory. EVIDENCE: Generally the home was maintained to a satisfactory standard. Some areas appeared in need of redecoration, and the manager stated that refurbishment of some areas is planned over the coming months. All areas of the home, plus a small garden area, are accessible to the service users residing there. The first floor has a shower room and two bathrooms. The shower room is currently not in use, as new flooring is due to be laid. One of the bathrooms is used as a store, meaning that all the service users residing on this floor use one bathroom. In addition, the shower room and storage bathroom doors were unlocked, creating a tripping hazard should a service user or visitor try to enter these areas. Provision of equipment was adequate. Service users stated that they are happy with their rooms, and rooms were observed to be personalised by the service user residing there. Park House Nursing Home DS0000012631.V268060.R01.S.doc Version 5.0 Page 14 All areas of the home were noted to be clean and tidy at the time of the inspection. Park House Nursing Home DS0000012631.V268060.R01.S.doc Version 5.0 Page 15 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 The home is adequately staffed. EVIDENCE: The staffing rota was viewed. staffing levels are: first floor: one nurse and three carers on an early shift, one nurse and two carers on a late shift, plus a twilight shift. On the ground floor there is one senior carer and two carers on an early and late shift. Night shifts are covered by one nurse and three carers. Staffing levels were considered adequate at the time of the inspection. Three staff members were noted to be working excessive hours. The manager stated that they had signed working time directive opt out agreements, and that their performance was monitored by her. Park House Nursing Home DS0000012631.V268060.R01.S.doc Version 5.0 Page 16 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): 37,38 The management of the home is satisfactory. EVIDENCE: A sample of policies and procedures were viewed. these documents had not been reviewed for 2.5 years, and must be reviewed as a matter of urgency. It is acknowledged that the policies and procedures are corporate documents, and reviewed centrally, however the manager may wish to review the existing documents in her possession, in the interim, to ensure that they reflect current and up to date practice. The laundry chutes on both floors were unlocked at the time of the inspection. One of these locks was broken. The manager assured the inspector that both doors would be locked before the end of the day. Therefore an immediate requirement was not made. Park House Nursing Home DS0000012631.V268060.R01.S.doc Version 5.0 Page 17 A service users general risk assessment form stated that she prefers to be assisted to eat, whilst laying flat in bed, however, risks associated with this were not identified. None of the bedroom doors had automatic door closures in place which would activate with the fire alarm. Advice must be sought from the fire officer in relation to this. Park House Nursing Home DS0000012631.V268060.R01.S.doc Version 5.0 Page 18 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 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 3 2 3 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X 2 2 Park House Nursing Home DS0000012631.V268060.R01.S.doc Version 5.0 Page 19 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 OP9 Regulation 13(2) Requirement Management of medication must be to an acceptable level in the following areas: 2. Recording of variable doses This was a previous requirement with a timescale of 31.5.05, which remains unmet. Advice from the fire officer must be sought in relation to the lack of automatic closures on the bedroom doors, and identified action taken. Management of medication must be to an acceptable level in the following areas: 1. Dressings must be prescribed for the individual on their medication administration record sheets. 2. where nursing care is provided, a service users pulse must be recorded before administering digoxin. Policies and procedures must be reviewed at least annually. Risk assessments must be in place, where risks are identified, DS0000012631.V268060.R01.S.doc Timescale for action 20/12/05 2 OP38 23(4) 01/01/06 3 OP9 13(2) 20/12/05 4 5 OP37 OP38 17 12(1) 01/01/06 20/12/05 Park House Nursing Home Version 5.0 Page 20 and contain all of the required information. This was a previous requirement with a timescale of 31.5.05, which remains unmet. 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 4 Refer to Standard OP7 OP8 OP19 OP21 Good Practice Recommendations The information relating to each service user should correspond throughout. Pressure area care records should be maintained consistently. Some areas of the home should be considered for refurbishment. Bathrooms used as storage areas should not pose a risk to service users or visitors to the home. Park House Nursing Home DS0000012631.V268060.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 DS0000012631.V268060.R01.S.doc Version 5.0 Page 22 - 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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