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Inspection on 22/06/05 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 22nd June 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

What has improved since the last inspection?

Some progress has been made with the requirements and recommendations from the last inspection. Overall the standard of record keeping in care records has improved although some inconsistencies were found. A nutritional and a falls risk assessment had been put in place in all but one of the records seen. The meals of residents who need a soft diet have improved and it is now possible to identify each component of the meal being offered. The majority of staff have attended training on the care of people with terminal illnesses.

What the care home could do better:

Pre-admission procedures must be followed for all future residents regardless of the intended length of stay. The Statement of Purpose must be updated and made available to allow people to make fully informed choice about whether the home is suitable to meet their needs. A number of shortfalls in relation to record keeping were found; many of these have been seen in previous inspections and must now be put right. While some progress has been made on staff training, and staff are praised for doing most of the training in their own time, this is an area that must be improved. Staff should be supported in developing their knowledge and skills. The home must make sure that all the required checks are completed before new staff start work in the home. A number of requirements and recommendations have been made in about these issues.

CARE HOMES FOR OLDER PEOPLE Park House Nursing Home Park Lane Queensbury Bradford BD13 1QJ Lead Inspector Mary Bentley Unannounced 22 June 05, 9.30am nd 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 Nursing Home J52 J03 S29237 Park House V230116 220605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Park House Address Park Lane Queensbury Bradford BD13 1QJ 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) 01274 817014 01274 818288 Kloriann Medicare Ltd Mrs Gwyneth Ormondroyd Care Home with Nursing 25 Category(ies) of Old age 25 Physical Disability (1) Terminally Ill 3 registration, with number of places Park House Nursing Home J52 J03 S29237 Park House V230116 220605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The place for PD is specifically for the service user named in the application form dated 20th May 2005. Date of last inspection .18/11/04 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 garden area. 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 J52 J03 S29237 Park House V230116 220605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection year runs from April to March and within that time, the CSCI must do a minimum of two inspections of all care homes. This was the first inspection for this year. It was unannounced and carried out between 9.30am and 3.30pm on 22 June 2005. The manager was not available on that day and a further visit was made on 30 June 2005 for three hours. Before the inspection time was spent planning the day. The purpose of this inspection was to assess the home against a predetermined selection of the National Minimum Standards for Older People and to check what progress had been made on meeting the requirements from the last inspection. The home prefers to use the term “resident” rather than “service user” therefore that will be used in this report. The methods used in this inspection included discussions with residents’, visitors, staff and management, examination of care records, indirect observation of care practices and looking at some parts of the home. Since the last inspection the CSCI has received one complaint about the home. The provider investigated this and the issues found were addressed, a summary of the complaint is available from the local CSCI office. The CSCI also received a letter of praise from the relatives of a former resident. Comment cards were left at the home to be given to residents and relatives. These cards provide an opportunity for people to share their views of the home with the CSCI. Comments received in this way will be shared with the provider without revealing the identity of those completing them. What the service does well: The home provides a pleasant, safe and comfortable environment for residents, the standard of décor and furnishings is good and residents and visitors said that the home is always clean. The home has a conservatory and a furnished patio, which allow residents and visitors to enjoy the attractive gardens. Residents said they were happy with the care they were receiving and visitors said they are always made welcome at the home. Residents are treated with respect and dignity. Both residents and relatives were confident that they could approach the management and that any concerns they had would be acted on. Park House Nursing Home J52 J03 S29237 Park House V230116 220605 Stage 4.doc Version 1.30 Page 6 Residents said they enjoyed the food and that their preferences are catered for. 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 J52 J03 S29237 Park House V230116 220605 Stage 4.doc Version 1.30 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 Nursing Home J52 J03 S29237 Park House V230116 220605 Stage 4.doc Version 1.30 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. Standard 6 does not apply to this service Future residents are not always given enough information to allow them to make a fully informed choice about the home. The needs of new residents are not always assessed before admission. EVIDENCE: A pre admission assessment had not been carried out for one resident recently admitted to the home for a short stay. She had not had the opportunity to visit the home and had chosen it because she lived nearby and had heard good things about it in the local area. She was very happy with the care she was receiving. The Statement of Purpose does not include information about the room sizes and has not been updated to reflect the recent changes to the registration categories. Requirements have been made about these standards. Park House Nursing Home J52 J03 S29237 Park House V230116 220605 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9, 10 and 11. Overall the health and personal care needs of residents are met despite this not being fully shown in the care records. Residents can be sure that they and their families will be treated with care, sensitivity and respect at the time of their death. EVIDENCE: The care records of four residents were looked at. A detailed assessment is now carried out for all residents and this is the basis of the care plans. In most cases care plans detailed how personal, health and social care needs would be met, however no care plans had been filled in for one resident who had recently been admitted. Although a falls risk assessment has been implemented this had not been filled in for one resident admitted with a history of falls. One resident who had a high risk of developing pressure sores was sat in a chair without a pressurerelieving cushion. The home’s pressure area care policy is based on national guidelines however it is not always followed. Park House Nursing Home J52 J03 S29237 Park House V230116 220605 Stage 4.doc Version 1.30 Page 10 The records showed that residents are able to see a range of health and social care staff. There are systems in place to make sure that residents have access to dental care and eye tests and see the dentist. One resident was dealing with her own medication; this was safely stored in her room. However a risk assessment had not been carried out as recommended by national guidelines. The records about the return of controlled drugs to the pharmacy had not been filled in two instances. The remainder of the records about medicines were up to date and good. There is usually one nurse on duty who gives all medicines; the home uses individual bottles rather than a pre-packed system. A lot of the nurses’ time is taken up with giving drugs reducing the time available for them to do other nursing duties. The commission received a letter from a relative of a resident who had recently died in the home, The family were very complimentary about the care and support that the home had given both to the resident and to the family. The home is using the Liverpool care pathway, this is a model of good practice for palliative care and many of the staff have recently been to training on this. The home has made links with community health care staff specialising in the care of the terminally ill. A number of requirements and recommendations have been made about these standards. Park House Nursing Home J52 J03 S29237 Park House V230116 220605 Stage 4.doc Version 1.30 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 standard(s) 13 & 15 Residents are supported to keep contact with family, friends and the local community as they wish. The home provides a good, varied and nutritious diet, which takes account of individual choices and is enjoyed by residents. EVIDENCE: Visitors said that they feel welcome to visit at any time and described the staff as welcoming. Visits can take place in private. One resident was going out with her family for the afternoon. The lunchtime meal was well presented and staff provided assistance when it was needed. The majority of residents had their meals in the dining room however some had their meals served in their rooms and one had her meal served outside on the patio. Residents said the food was good and that their dietary choices are catered for. Park House Nursing Home J52 J03 S29237 Park House V230116 220605 Stage 4.doc Version 1.30 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 standard(s) 16 & 18 Complaints are dealt with appropriately and residents are protected from abuse. EVIDENCE: The complaints procedure is prominently displayed and complaints are recorded. One relative said they had recently raised a concern with the home’s management. She was satisfied with the way this had been dealt with and said she would have no hesitation in speaking to the manager if she had any further concerns. In dealing with this complaint the manager showed that she is familiar with the local authority adult protection procedures. All the staff are booked on adult protection training with the local authority and are waiting for places to be available. Information on adult protection is circulated within the home. Park House Nursing Home J52 J03 S29237 Park House V230116 220605 Stage 4.doc Version 1.30 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 standard(s) 19, 20, 21 and 24. Residents live in a pleasant, comfortable and safe environment and have access to safe outside space. EVIDENCE: Residents and relatives said that the home is always clean. There is ongoing decoration and refurbishment. The owner said that all the recommended improvements to fire safety have been completed. Communal areas and bedrooms are decorated to a good standard and the furnishings are appropriate for the needs of residents. In all the bedrooms seen residents had personal belongings around them. Door locks have been fitted to all bedroom doors, except those that provide access to fire exits. The home has two assisted bathrooms; this falls short of the national minimum standard, which recommends a ratio of 1 to 8. Park House Nursing Home J52 J03 S29237 Park House V230116 220605 Stage 4.doc Version 1.30 Page 14 A requirement has been made about one of these standards. Park House Nursing Home J52 J03 S29237 Park House V230116 220605 Stage 4.doc Version 1.30 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 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) 27, 28 & 29 The numbers of staff on duty were enough to meet residents’ needs. Recruitment procedures do not make sure that residents are protected. EVIDENCE: Residents and relatives said there are enough staff available, one resident said that she had some difficulty making herself understood by some staff whose first language was not English. Duty rosters are available for all staff. Two of the eleven care staff have an National Vocational Qualification (NVQ), this is 18 . The target set by the national minimum standards is to have 50 of care staff qualified to NVQ level 2 by 2005. The staff files seen showed that all the pre-employment checks are not completed before new staff start work in the home. Requirements have been made about two of these standards. Park House Nursing Home J52 J03 S29237 Park House V230116 220605 Stage 4.doc Version 1.30 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 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) 31, 32, 33, 36 & 38 Residents and relatives were satisfied with management arrangements despite the home’s lack of a formal approach to quality assurance and quality monitoring. The failure to give regular training in safe working practices allows the opportunity for residents and staff to be at risk. EVIDENCE: Residents and relatives spoken with described the management as very approachable; relatives said they were kept informed and consulted. There are no formal systems for seeking the views of residents, relatives and other health and social care professionals involved with the home. The manager is a nurse with several years experience in the care of older people however she has not completed the registered managers award. Some staff have had appraisals but there has been no progress with the plan to implement a system of formal supervision for staff. Park House Nursing Home J52 J03 S29237 Park House V230116 220605 Stage 4.doc Version 1.30 Page 17 Seven of the eleven care staff employed at the home have not done moving and handling training in the last 12 months. Training on fire safety was carried out in June 2005 and October 2004; the records showed that not all staff had been to fire training twice within 12-months. Requirements have been made about these standards. Park House Nursing Home J52 J03 S29237 Park House V230116 220605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 2 x x 3 x x STAFFING Standard No Score 27 3 28 2 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 2 3 2 x x 1 x 2 Park House Nursing Home J52 J03 S29237 Park House V230116 220605 Stage 4.doc Version 1.30 Page 19 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 1 Regulation 4 Schedule 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 and 25/02/05 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. Future residents must not be admitted until a comprehensive assessment of their needs has been done. Care plans must provide evidence of consultation with residents and/or their representatives. Previous timescale of 29/10/04 and 25/02/05 not met. Care plans must be availabe for all residents in the home. A falls risk assessment and care plan must be availabe for residents with a history of falls. Previous timescale of 30/09/04 and 25/02/05 not met. Park House Nursing Home J52 J03 S29237 Park House V230116 220605 Stage 4.doc Version 1.30 Page 20 Timescale for action 31 August 2005 2. 3 14 31 August 2005 28 September 2005 3. 7 15 4. 5. 7 8 15 13(4) 31 August 2005 31 August 2005 6. 7. 9 18 13(2) 13(6) Accurate records must be kept of all medicines disposed of and/or returned to the pharmacy. The registered persons must ensure that staff receive training on adult protection procedures and issues relating to abuse. Previous timescales of 29/10/04 and 25/02/05 not met. The registered persons must make sure that there are enough baths/showers to meet the needs of residents. Previous timescae of 25/03/05 not met. 50 of care staff should achieve NVQ level 2 or equivalent within the timescale. 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 not met. Staff must be given suitable help to do further training and qualifications. Carried forward from the last inspection. The manager must complete the registered managers award within the timescale. 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. Previous timescales of 29/11/04 and 25/02/05 not met. 31 August 2005 12 October 2005 8. 21 23(2)(j) 26 October 2005 9. 10. 28 29 18 19 31 December 2005 31 August 2005 11. 30 18 28 September 2005 12. 13. 31 33 9 & 10(3) 24 31 December 2005 26 October 2005 Park House Nursing Home J52 J03 S29237 Park House V230116 220605 Stage 4.doc Version 1.30 Page 21 14. 36 18 Care staff must have formal supervision at least six times a year. Previous timescales of 29/10/04 and 25/02/05 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 and 16/12/04 not met. 28 September 2005 15. 38 13(5) & 23(4) & 18 31 August 2005 16. 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 8 9 Good Practice Recommendations Pressure area care should follow the homes policy. A larger cupboard for the storage of controlled drugs should be provided. It is recommended that the home should use a monitored dosage system for giving medicines. A written risk assessment should be done for residents who do their own medication. The supernumerary time given to the manager should be kept under review to make sure that she has enough time to do the record keeping and staff training. Carried forward from the last inspection It is recommended that the home involve an independent advocate for those service users whose financial affairs are managed by the home. Carried forward from the last inspection. 3. 27 4. 35 Park House Nursing Home J52 J03 S29237 Park House V230116 220605 Stage 4.doc Version 1.30 Page 22 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 J52 J03 S29237 Park House V230116 220605 Stage 4.doc Version 1.30 Page 23 - 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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