Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 28/04/05 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 28th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

The service users stated that their needs are met, and staff spoken to demonstrated a good knowledge of the needs of the service users in their care. Healthcare assessments were recorded appropriately. The kitchen met with the requirements of the Environmental Health Department, and service users stated that the food is nice, and they have a choice. Service users were appropriately protected by the policies and procedures relating to complaints and abuse. Staffing levels were adequate to meet the needs of the service users. The management of the home is carried out to a very high standard. Staff at all levels were noted to have a pleasant manner with the service users. Staff are appropriately supervised. Service users money, held by the home, was handled appropriately

What has improved since the last inspection?

The content of care plans has improved to more clearly demonstrate the service users needs. Risk assessments were in place for service users who self medicate their medication. Some refurbishment has been undertaken. Service users weight was being recorded more regularly than previously. Chemical storage was appropriate. Although still requiring improvement, medication management had improved since the last inspection

What the care home could do better:

Service users rights and safety is put at risk by the company refusing to issue service users with contracts of residency. The statement of purpose does not fully inform service users, about the home. Service users are not always involved in the formulation of their care plan. Medication management has improved, but still requires some attention to ensure safe practices are maintained. Policies and procedures advising staff have not been reviewed for two years, meaning they may be out of date. Staff have been employed in the home without the required checks being carried out. This practice is potentially putting service users at risk. An immediate requirement has been made in relation to this, and the manager stated that these staff would not be rotered on duty until the situation is rectified. Staff should not be rotered to work double shifts.

CARE HOMES FOR OLDER PEOPLE Park House Nursing Home 50 Park Road Wellingborough Northants NN8 4QE Lead Inspector Sarah Smart Unannounced 28th April 2005 10.00 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 v224252 c51 c08 s12631 park house v224252 280405 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Park House Nursing Home Address 50 Park RoadWellingboroughNorthantsNN8 4QE 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) 01933 443883 01933 279844 Four Seasons Homes Limited Mrs Pamela Mary Band Care Home with Nursing 42 Category(ies) of DE(E) Dementia – Over 65 (6)OP Old Age registration, with number (42)TI(E) Terminal Illness – Over 65 (42)PD(E) of places Physical Disability – Over 65 (10) Park House Nursing Home v224252 c51 c08 s12631 park house v224252 280405 stage 4.doc Version 1.40 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.2. 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 home3. 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 home4. 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 home5. To be able to admit the named person in variation application dated 20th May 2004 number V000014766 Date of last inspection 2nd February 2005 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 usersThe home provides residential and nursing care.. Park House Nursing Home v224252 c51 c08 s12631 park house v224252 280405 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was undertaken between the hours of 11.20am and 3.50pm. The pre-inspection questionnaire had not been sent to the home for completion, and will be used at the next inspection. Written feedback in the form of questionnaires was received from service users or relatives at this time. 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, staff files, quality assurance, service users finances, staff supervision, accident records, complaints records, previous requirements made, and staff and service user interviews. Two staff members, plus the manager, were interviewed at length, and several others briefly, whilst four service users were spoken to in detail, and one relative. Two service users were case tracked What the service does well: The service users stated that their needs are met, and staff spoken to demonstrated a good knowledge of the needs of the service users in their care. Healthcare assessments were recorded appropriately. The kitchen met with the requirements of the Environmental Health Department, and service users stated that the food is nice, and they have a choice. Service users were appropriately protected by the policies and procedures relating to complaints and abuse. Staffing levels were adequate to meet the needs of the service users. The management of the home is carried out to a very high standard. Staff at all levels were noted to have a pleasant manner with the service users. Staff are appropriately supervised. Service users money, held by the home, was handled appropriately Park House Nursing Home v224252 c51 c08 s12631 park house v224252 280405 stage 4.doc Version 1.40 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 v224252 c51 c08 s12631 park house v224252 280405 stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Park House Nursing Home v224252 c51 c08 s12631 park house v224252 280405 stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4 The company are seriously failing to adequately inform the service users, and therefore putting them at risk. Despite a lack of fully completed assessments the service users needs are met EVIDENCE: The statement of purpose fell short of giving the information required by schedule one in many areas. This document, although lengthy, had previously been a great deal more comprehensive, and the manager was unable to explain where such information had gone. Seven of the eighteen areas were not addressed at all, and a further 4 were only covered partially. Despite numerous previous requirements the company have failed to introduce service user contracts. They have failed to achieve this target, despite it being set by them. By not issuing service users with a contract of residency the company is putting service users at risk of abuse, particularly financial abuse. The company is also putting itself at risk from allegations of financial abuse, and financial loss. In the interim, the manager is strongly recommended to issue service users with as much information as possible in writing. Of the two service users case tracked, one had the assessments fully completed. The seconds assessments were partially filled in, meaning that a clear indication of the service users needs was not available. Park House Nursing Home v224252 c51 c08 s12631 park house v224252 280405 stage 4.doc Version 1.40 Page 9 Service users spoken to by the inspector stated that their needs are met. Staff spoken to demonstrated a very good knowledge of the needs of the service users in their care. Park House Nursing Home v224252 c51 c08 s12631 park house v224252 280405 stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9, 10, Service users healthcare needs are met, however service users involvement, and documentation, could be improved upon EVIDENCE: Care plans were written to a satisfactory standard, were reviewed, and had future review dates set. Neither of the files viewed contained evidence of service users involvement in their writing, however the manager advised that the majority do now contain the service user or a relative’s signature. With the exception of one, all healthcare assessments were in place, regularly reviewed, and accurately recorded. Records of GP visits were maintained. The ground floor is predominately residential service users. Medication is stored on each floor. Variable doses were not always recorded. A service user, who self medicates, had a risk assessment in place relating to this. One medicines recommended storage was in a fridge, however it was found in the drug trolley. A senior carer rectified this at the time of the inspection. On the first floor, variable doses were recorded, although the medication administration record sheets contained several gaps in the recording, where neither signatures nor codes had been entered. The controlled drug register Park House Nursing Home v224252 c51 c08 s12631 park house v224252 280405 stage 4.doc Version 1.40 Page 11 had not been fully completed. In one instance a service user was receiving digoxin, however their pulse was not being recorded. The confidentiality policy did not give instruction to staff regarding disclosing information over the telephone, contact with the media, or conversations between staff outside work. Park House Nursing Home v224252 c51 c08 s12631 park house v224252 280405 stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15 (partially) Service users wishes and choices are respected. EVIDENCE: The Environmental Health Officer was also in the home on this occasion. Therefore the kitchen area was not viewed, although his report stated that all was satisfactory. Service users stated that they are happy living in the home, and are able to make choices, including a choice of food. Service users stated that the food is nice Park House Nursing Home v224252 c51 c08 s12631 park house v224252 280405 stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17,18 The home adequately protects the service users EVIDENCE: The complaints policy contained all of the required information, however as with other policies it had not been reviewed for two years despite a previous requirement. Staff spoken to demonstrated a good knowledge of the complaint handling procedure. The complaint record was viewed. The home have not received any complaints since the last inspection. Several service users spoken to stated that they do not wish to vote in the forthcoming elections. The home have a copy of the Northamptonshire inter-agency policy on abuse, as well as their own policy, which was satisfactory however unreviewed. Staff spoken to by the inspector demonstrated a good knowledge of the abuse policy. Park House Nursing Home v224252 c51 c08 s12631 park house v224252 280405 stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed during this inspection EVIDENCE: These standards were not assessed during this inspection. The bathroom floors were being replaced at the time Park House Nursing Home v224252 c51 c08 s12631 park house v224252 280405 stage 4.doc Version 1.40 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) 27,29,30 Staffing levels were adequate to meet the current needs of the service users. Service users were not protected by the recruitment practices and staff training EVIDENCE: The staff rota was viewed. Staffing is separated into staffing for the ground or residential floor, and staffing for the nursing or first floor. On the first floor a trained nurse is on duty 24 hours per day. In addition the morning shift is covered by three carers, and the afternoon by 2 carers. On the ground floor day shifts are covered by one senior carer and two carers. Over night there is one nurse and three carers covering the entire home. Two staff were noted to be working very long shifts, by working a late shift, immediately followed by a night shift. The manager stated that this occurred in an emergency situation when the night nurse rang in sick with short notice. The performance of staff working extra hours should be monitored to ensure that the effects of fatigue does not impact upon the service users. Staff files did not contain the correct documents to protect the service users. Two staff files did not contain Criminal Records Bureau checks, and the inspector advised that there is also a third. Two of the three Criminal Records Bureau checks have been received by the employee, but not by the home manager. An immediate requirement was made to ensure that staff do not work at the home without Criminal Records Bureau checks. The manager stated that these staff will not be rotered on duty until this situation is rectified. Park House Nursing Home v224252 c51 c08 s12631 park house v224252 280405 stage 4.doc Version 1.40 Page 16 One staff member spoken to by the inspector stated that she had not received moving and handling training. The manager stated that this was included in her induction training although there was no documentary evidence to support this. The manager stated that she would receive further training at the earliest opportunity Park House Nursing Home v224252 c51 c08 s12631 park house v224252 280405 stage 4.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33, 35,36,37,38 The home is managed successfully, and professionally. Despite risk assessments requiring more detail, service users interests and health and safety are protected. EVIDENCE: The manager has recently completed her Registered Managers Award, and is awaiting certification. The manager demonstrated an excellent relationship with her staff, and the service users in the home. Staff spoken to by the inspector demonstrated a clear understanding of their roles and responsibilities. Quality monitoring is undertaken by distributing surveys to service users and relatives, and by holding service user or staff meetings. The company also send out questionnaires. The manager also writes a regular and informative newsletter. Park House Nursing Home v224252 c51 c08 s12631 park house v224252 280405 stage 4.doc Version 1.40 Page 18 A sample of service users monies demonstrated that this is stored appropriately, and satisfactory recording maintained. Staff files contained records of staff supervision. The policies and procedures put in place in the home by the company have not been reviewed for two years. The confidentiality policy should contain additional information. Accident records demonstrated that there are relatively few accidents in the home. In some instances the reviews following accidents were not being recorded, and the accidents were recorded on loose leaf papers, which were not numbered, giving the potential for records to be lost. Risk assessments did not identify the risk, meaning that these documents were unclear as to the service users needs. One service user who smokes unsupervised in her bedroom did not have a risk assessment carried out in relation to this. Park House Nursing Home v224252 c51 c08 s12631 park house v224252 280405 stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 1 2 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 x 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 x 2 x 3 3 2 2 Park House Nursing Home v224252 c51 c08 s12631 park house v224252 280405 stage 4.doc Version 1.40 Page 20 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 2 Regulation 5 Requirement Previous requirement made 29.5.03, timescale: by 31.7.03. Each service user must be issued a contract of residency in order to protect the service user and the home Previous requirement 2.02.05, timescale: by 1.5.05. The manager should ensure that the version of the statement of purpose given to service users includes all of the information outlined in schedule 1. Previous requirement 6.7.04, timescale: by 15.9.04. The care plans must demonstrate the service users involvement in their writing. Management of medication must be to an acceptable level in the following areas:1. Recording associated with controlled drugs2. Recording of variable doses3. Gaps in signatures or codes IMMEDIATE REQUIREMENTStaff must have appropriate Criminal Records Bureau checks before commencing employment Staff must have undergone training, including statutory Timescale for action 30.05.05 2. 1 4 30.05.05 3. 7 15(1) 30.05.05 4. 9 13(2) 31.5.05 5. 29 19 29.4.05 6. 30 18(1)(c)(i ) 31.5.05 Page 21 Park House Nursing Home v224252 c51 c08 s12631 park house v224252 280405 stage 4.doc Version 1.40 7. 8. 9. 10. 11. 12. 13. 14. 15. 38 12(1)(a) training, and adequate records kept. Risk assessments must be in place, and contain all of the required information 31.5.05 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. 5. 6. 7. Refer to Standard 24 2 3 10 Good Practice Recommendations The manager should monitor the worn carpets, and replace as soon as possible. The manager should introduce a method of providing service users with the information required until the contracts of residency are available. Assessments should be fully completed The confidentiality policy should contain additional information Park House Nursing Home v224252 c51 c08 s12631 park house v224252 280405 stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 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 v224252 c51 c08 s12631 park house v224252 280405 stage 4.doc Version 1.40 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!