Inspection on 07/08/06 for Park House Nursing Home

This inspection was carried out on 7th August 2006.

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.

Other inspections for this house

Park House Nursing Home 14/08/07

Park House Nursing Home 21/11/05

Park House Nursing Home 28/04/05

Park House Nursing Home 02/02/05

Park House Nursing Home 06/07/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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 50 Park Road Wellingborough Northants NN8 4QE Lead Inspector Mrs Linda Preen Unannounced Inspection 7th August 2006 10:00 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 DS0000012631.V306576.R01.S.doc Version 5.2 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. DS0000012631.V306576.R01.S.doc Version 5.2 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 (wholly owned subsidiary of Four Seasons Health Care 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) DS0000012631.V306576.R01.S.doc Version 5.2 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 falling 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 21st November 2005 2. 3. 4. 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. The home is laid out over two floors with a small outside area which is accessible to service users. The home provides residential and nursing care to residents of both sexes who are elderly. Fees range from £340 to £560 per week according to resident assessed needs. DS0000012631.V306576.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two hours were spent prior to the inspection reviewing previous requirements and recommendations and collating information provided by the service. The inspection took place over a period of six hours as part of the statutory inspection programme. This requires that all homes be inspected at prescribed periods during the year. Four residents were chosen in order that their experience in the home could be assessed. The method used was “Case Tracking”. This involved looking at their records, talking to them and also to the staff concerning the care received. In addition to this staff rotas and training records, medication records and Health and Safety records were seen. A limited tour of the environment was undertaken. What the service does well: What has improved since the last inspection? Corridor areas have been redecorated to provide a pleasant place in which to live. New carpets for these areas are currently on order. Medication systems have been improved to ensure that prescription records are clear and residents are protected from harm. DS0000012631.V306576.R01.S.doc Version 5.2 Page 6 Risk assessments are in place for identified areas except the use of “cot sides.” All policies and procedures in the home have been reviewed to ensure that they are up to date and contain current good practice guidelines. 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. DS0000012631.V306576.R01.S.doc Version 5.2 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 DS0000012631.V306576.R01.S.doc Version 5.2 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, 2, 3, 4 and 5 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Service users are able to make an informed choice about the home, knowing that their needs will be met. EVIDENCE: An up to date Statement of Purpose and Service User Guide are available, which explain the services provided. Residents are invited to visit the home prior to admission, and two residents spoken to confirmed that they had done this. Comprehensive assessments are completed prior to admission in order that the home may assess if residents identified needs can be met. Each resident is issued with a copy of Terms and Conditions of residence on admission so that they may be aware of services provided, arrangements for payment of fees and notice periods required. DS0000012631.V306576.R01.S.doc Version 5.2 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 and 10 Quality in this outcome group is adequate. This judgement has been made using available evidence, including a visit to the service. Service users health and personal care needs are met but recording systems need more work in order that unfamiliar staff are aware of resident needs. Adequate medication systems are in place. EVIDENCE: Residents seen appeared clean and well groomed. Those spoken to were complimentary concerning the care and attention provided and several said that staff were very kind. Staff were observed to be treating residents with due regard to their dignity and respect. Relatives spoken to expressed their satisfaction with the home. A selection of residents was chosen to case track in order that their experience within the home could be assessed. This involved looking at their records, speaking to them and to the staff involved in their care. Care plans had been provided for assessed needs but these did not always contain sufficient detail to guide unfamiliar staff in caring for residents. For example: general statements such as “pressure relieving equipment provided” and “wears pads” were seen with no explanation as to what equipment was being used. Records of pressure ulcers and their treatment/progress were available, DS0000012631.V306576.R01.S.doc Version 5.2 Page 10 but were insufficiently detailed to enable nurses to assess changes from previous dressing changes. Where dressings were stated in care plans, these were not always prescribed or available and alternatives were in use. Advice was given concerning more suitable formats for recording wounds in the home. Residents who had “cot sides” to prevent them falling out of bed, in situ, did not have consent for this restraint recorded and one resident did not have the necessary padding to prevent injury from this equipment. The registered manager stated that this was the resident’s choice, but there was no evidence of this in her records and no risk assessment completed. Systems for the ordering, recording, storage and disposal of medication were seen and found to be satisfactory with the exception of the prescription of dressings which were either not prescribed at all or were different to the ones stated in the care plan. This was a requirement at the last inspection and remains outstanding. DS0000012631.V306576.R01.S.doc Version 5.2 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 and 15 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Social Activities and meals are both well managed, creative and provide daily interest and variation for people living in the home. EVIDENCE: Evidence of resident’s lifestyle, including their hobbies and interests was recorded in the files seen. An activities co-ordinator is employed and she arranges such things as Card games, dominoes, Bingo, and church services as well as outside entertainers. Some residents were enjoying a church service during the inspection. A visit from a clothing company was arranged for the week following the inspection in order that residents unable to go out could purchase their own choice of clothes. Staff stated that some residents go out with relatives and one gentleman was collected by relatives to go out during the morning of the inspection. Visitors are welcome at any time, and the Registered Manager greeted all in a friendly manner. They are able to make tea and coffee in the small kitchenette areas in the dining rooms. All of the residents spoken to stated that the standard of food was good and that they are offered a choice. One gentleman said he particularly liked his cooked breakfast. Lunch was observed and this looked and smelled appetising. Records of food likes and dislikes were seen in resident files and records of DS0000012631.V306576.R01.S.doc Version 5.2 Page 12 food and fluid intake were kept for those who had an identified need in this area. DS0000012631.V306576.R01.S.doc Version 5.2 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 the following standard(s): 16 and 18 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Residents may be confident that their concerns will be addressed and that they will be protected from abuse. EVIDENCE: A complaints procedure is available for residents and relatives. There have been no complaints received by the Commission for Social Care Inspection or by the home since the last inspection. Northamptonshire County Council had investigated one complaint but this had been unfounded. Staff recruitment procedures include Criminal Records Bureau checks to protect residents from possible abuse. Staff receive training in the Protection of Vulnerable Adults, and the carer spoken to was aware of the different types of abuse and her responsibility to report any concerns. DS0000012631.V306576.R01.S.doc Version 5.2 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 the following standard(s): 19, 20, 23, 24, 25 and 26 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Residents live in homely surroundings, which are well maintained and clean. EVIDENCE: A limited tour of the environment demonstrated that the home was clean and tidy and maintained to a good standard. Corridor areas had been redecorated since the last inspection and the Registered Manager stated that new carpets were on order for these areas. In addition, there are plans to provide new cupboards and laminate flooring in the dining rooms. Resident rooms showed evidence of personalisation, with small items of furniture, pictures and ornaments in evidence. Several residents have their own televisions in order to watch individual choices of programmes. One gentleman was enjoying watching a Cricket Match in his room. A pleasant patio area is provided for residents use in good weather and one gentleman was enjoying sitting in the sun during the afternoon. DS0000012631.V306576.R01.S.doc Version 5.2 Page 15 DS0000012631.V306576.R01.S.doc Version 5.2 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 and 30 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Procedures for the recruitment of staff provide safeguards necessary to offer protection to the people living in the home. Staff are provided with training and are in sufficient numbers to meet the needs of the residents. EVIDENCE: Staffing levels appear adequate to meet the needs of the current resident group. In addition to the Registered Manager, a second Registered Nurse is on duty as well as a senior carer and five care staff in the morning. In the afternoon, there is one Registered Nurse, one senior carer and three care staff and at night there is one Registered Nurse and three carers. A selection of staff files was seen. This demonstrated that recruitment systems are in place with the required checks to ensure the residents are protected from harm. An equal opportunities policy is in place and staff from different ethnic groups and a range of ages are employed. Staff training records demonstrate that statutory training is provided in Fire, moving and handling, Health and Safety and Food Hygiene. Although many of the carers are experienced and have worked with this group of residents for some time, only six care staff out of twenty hold a National Vocational Qualification in care, which gives them a basic understanding of resident’s care needs. The Registered Manager was reminded of the requirement that 50 of carers should hold this qualification. DS0000012631.V306576.R01.S.doc Version 5.2 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 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, 32, 33, 35 and 38 Quality in this outcome group is adequate. This judgement has been made using available evidence, including a visit to the service. The Registered Manager ensures that the home is run efficiently, in a way that serves the best interests of the residents, but more attention is needed to Health and Safety issues in the home. EVIDENCE: The Registered Manager is an experienced First Level Registered nurse who holds the Registered Manager’s award. Staff and residents complimented her on her openness and willingness to listen to suggestions and problems, and to try to find solutions. Quality Assurance systems are in place and the results of an internal audit and relatives survey were seen Relatives had made positive comments about the home such as: “Having visited the home many times, I like the atmosphere, the attitude of the staff and the general friendliness of the home.” DS0000012631.V306576.R01.S.doc Version 5.2 Page 18 Systems for the control and recording of resident’s pocket money accounts were seen to be satisfactory, and protected residents from potential abuse and staff from allegations of theft. Records of the testing of fire alarms and emergency lighting were seen. These had been done at the required intervals until the sixteenth of June, had been checked on the eighteenth of July but then no further checks had been done. The registered Manager stated that the maintenance man had left and he had been responsible for these checks. She was reminded of the importance of these records being maintained to ensure the safety of residents and staff. A requirement was made in this respect. Some resident’s doors are wedged open, which would be dangerous in the event of a fire. The company were required to seek advice from the fire officer concerning this following the last inspection and this requirement remains outstanding. Staff files demonstrated that an induction programme was in place for new staff to ensure the safety of residents, and staff spoken to confirmed this. DS0000012631.V306576.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 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 3 17 X 18 3 3 3 X X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 2 DS0000012631.V306576.R01.S.doc Version 5.2 Page 20 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 OP38 Regulation 23(4) Requirement Advice from the fire officer must be sought in relation to the lack of automatic closures on the bedroom doors, and identified action taken. Previous timescale of 01/01/06 not met. Dressings must be prescribed for the individual on their medication administration record sheets. Previous timescale of 20/12/05 not met. Records of the testing of fire alarms and emergency lighting must be available to demonstrate that these have been tested at the required intervals. Timescale for action 01/09/06 2. OP9 13(2) 01/09/06 3 OP38 13(2) 01/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. DS0000012631.V306576.R01.S.doc Version 5.2 Page 21 No. 1. 2. Refer to Standard OP7 OP8 Good Practice Recommendations Care plans should be expanded to ensure that information for each resident is detailed and specific to their individual needs. Records of the treatment and progress of wounds should be reviewed to ensure that they are research based and give sufficient information to other health care professionals. Risk assessments should be in place for all residents assessed as requiring “cot sides”. All such “cot sides” should be fitted with suitable padding to prevent residents from entrapment. 3 OP8 DS0000012631.V306576.R01.S.doc Version 5.2 Page 22 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 DS0000012631.V306576.R01.S.doc Version 5.2 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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