Inspection on 14/09/06 for Park House Rest Home

This inspection was carried out on 14th September 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Park House Rest Home 18/12/08

Park House Rest Home 04/02/08

Park House Rest Home 16/02/06

Park House Rest Home 09/08/05

Park House Rest Home 04/11/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Park House Rest Home 220 Havant Road Hayling Island Hampshire PO11 0LN Lead Inspector Michael Gough Unannounced Inspection 14th September 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 Park House Rest Home DS0000062008.V305520.R02.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. Park House Rest Home DS0000062008.V305520.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park House Rest Home Address 220 Havant Road Hayling Island Hampshire PO11 0LN 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) 02392 730613 Ms Sally-Jayne Hoke Mr Lee John Gosling Miss Georgina Mitton Care Home 16 Category(ies) of Dementia (DE) (3) (Both), Mental disorder, registration, with number excluding learning disability or dementia of places (MD)(3)(Both),Dementia - over 65 years of age (DE(E))(16) (Both),Old age, not falling within any other category (OP)(16)(Both) Park House Rest Home DS0000062008.V305520.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the DE and MD category may only be admitted over 55 years of age. 16th February 2006 Date of last inspection Brief Description of the Service: Park House is a detached residential care home situated within its own grounds, in a quiet residential area of Hayling Island. The home is registered with the Commission for Social Care Inspection (CSCI) to accommodate up to a maximum of 16 service users. The home benefits from a large rear garden and the front of the property is gravelled, with hanging baskets and flowers in the borders and provides parking for approximately 6 vehicles. The home is on a local bus route and the seafront at Hayling Island is within easy reach. The home meets the individual accommodation space requirements set out in the National Minimum Standards (NMS) 3rd edition for existing providers. Fees at the home range from £385 to £450 per week and service users are responsible for paying for their own toiletries, hairdressing, chiropody and items of a personal or luxury nature. Park House Rest Home DS0000062008.V305520.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection took place on the 14 September 2006, the inspection took place over 3.5 hours and the inspector was assisted throughout by one of the registered providers. Evidence for this report was obtained by speaking with the provider, from reading and inspecting records, touring the home and from observing the interaction between staff and service users. It was not possible to gain the views of all the service users due to their dementia, however the inspector did speak with a number of service users and also 4 members of staff. What the service does well: What has improved since the last inspection? What they could do better: Care plans at the home provide information for staff, however the daily recording needs to be improved to show what care has been delivered or if their needs are fully met and this is not in the best interests of service users. The homes recruitment policy and practice generally supports and protects service users, however not all of the required staff recruitment records were available at the home . Park House Rest Home DS0000062008.V305520.R02.S.doc Version 5.2 Page 6 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 Rest Home DS0000062008.V305520.R02.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 Park House Rest Home DS0000062008.V305520.R02.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): 3&6 Quality in this outcome area is “good”. This judgement has been made using available evidence including a visit to the service. New service users have a needs assessment undertaken prior to moving into the home this allows both the home and the service users to see if the home can meet the service users needs. The home does not provide intermediate care. EVIDENCE: The registered provider carries out an individual needs assessment prior to service users moving into the home using an assessment form to obtain relevant information about any potential new service user. The homes manager then continues the assessment process during the first 2-3 weeks of the service users stay. Social services also carry out assessments for any service user who is funded by the local authority. Assessments were on file at the home. Intermediate care is not provided by the home. Park House Rest Home DS0000062008.V305520.R02.S.doc Version 5.2 Page 9 Park House Rest Home DS0000062008.V305520.R02.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is “good”. This judgement has been made using available evidence including a visit to the service. The health, personal and social care needs of service users are set out in an individual plan of care, however the daily recording needs to be improved to show what care has been delivered or if their needs are fully met and this is not in the best interests of service users. The home ensures that all service users have access to all relevant health care professionals and the health care needs of service users are met. Service users are protected by the home policies and procedures for dealing with medicines. Service users at the home are treated with dignity and respect and their right to privacy is upheld. EVIDENCE: Park House Rest Home DS0000062008.V305520.R02.S.doc Version 5.2 Page 11 Care plans were seen for 3 service users and these were clear and easy to follow and contained relevant information and informed staff of individual needs and how these should be met, however monthly recording and daily recording did not give clear information on what care had been given or if there were any specific needs for individual service users, notes stated “had a good evening” or “ quite cheerful today” but did not provide evidence on care delivery. Daily notes for one service user stated that she had a sore under her left breast but there was no information for staff to monitor this and notes for the next day gave no mention if this sore was still there or if it had improved or deteriated. It is a requirement that the home must improve the daily and monthly recording procedures in the home to provide clear evidence of care delivery. It was not possible to get the views of service users due to their dementia but observations showed that staff were very attentive, supporting service users to the bathroom, engaging them with conversations, keeping service users stimulated with chats and hand massages. Staff and service users seemed to get on well together and there was a good atmosphere in the home. All of the service users are registered with a local GP practice on Hayling Island, although they are free to choose their own doctor if they wish. Arrangements are made for dental checks to be carried out in the local community and an optician visits the home regularly, although some service users visit an optician in the local community. The local health centre provides service users with access to all relevant health care professionals and a visiting chiropodist calls every 4-6 weeks. The home has a policy for the receipt; storage, return and administration of medication and all staff at the home who administer medication have undertaken appropriate training. The home uses a monitored dose system from a local pharmacy and the medication records sheets were inspected and found to be up to date and correct. The home has some controlled drugs, temazepam for 2 service users and these are stored in a locked box inside the medication cabinet and there was a controlled drug register, which was up to date with dual signatures. The dispensing pharmacist provides a returns service for the disposal of any unwanted medication, including controlled drugs and appropriate records were kept. Park House Rest Home DS0000062008.V305520.R02.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is “good”. This judgement has been made using available evidence including a visit to the service. The home provides a range of activities for service users, which meets their expectations and the religious and recreational interests of service users at the home are provided for. Service users are able to maintain contact with family and friends and visitors are welcome at any time. Service users are supported to exercise choice and control over their lives and are provided with a wholesome and balanced diet in pleasant surroundings at a time convenient to them. EVIDENCE: Activities at the home include bingo, games with the staff, skittles, musical movement, video’s, gardening, trips out and visiting entertainers. On the day of the inspection staff were observed interacting with service users and engaging with them to provide stimulation, other service users were watching TV and walking around the home. Due to the nature of service users dementia it was not possible to talk directly to service users and ask them specific questions as to how the home matches their expectations. However those service users spoken to appeared to be happy and content at the home. The home does not keep a record of activities provided and there was no record of who took part in activities at the home. It was recommended that Park House Rest Home DS0000062008.V305520.R02.S.doc Version 5.2 Page 13 the home keep a record to provide evidence of the activities provided at the home. Visitors to the home are welcome at any time and the visitor’s book showed that there are regular visitors to the home. During the inspection the inspector did not have the opportunity to speak with any visitors, however there were clear details of the homes visiting policy displayed in the home. Service users are able to make informed choices and are supported are able to control their own lives as much as possible, the inspector observed staff consulting service users about day to day living in the home and staff respected their views. There were no restrictions on bathing and there was evidence in care files of service users preferences for when they would like to go to bed and get up and the home ensured that service users wishes were acted upon. A number of service users had bought some of their own possessions into the home and rooms had been personalised. The home operates a four-week rolling menu and on the day of the inspection lunch was Beef Pie, with fresh carrots & cabbage, this was followed by apple pie & custard. The cook stated that staff inform service users of the daily menu and alternatives can be provided for those who do not like the main choice of the day. A record is kept of any meals that are not the main choice. The evening meal was normally a snack type meal and service users were able to have a drink or a snack at any time of the day or night. Meals are normally taken at a large table in the dining room but service users are able to eat their meals in their own rooms or elsewhere if they prefer. Staff were observed supporting service users appropriately at lunchtime on the day of the inspection. Park House Rest Home DS0000062008.V305520.R02.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is “good”. This judgement has been made using available evidence including a visit to the service. There is a simple, clear and accessible complaints procedure, which includes timescales for the process and any complaints are logged and responded to appropriately. The homes policies and procedures protect service users from any form of abuse. EVIDENCE: Service users spoken to were not fully aware that the home had a complaints procedure due to their dementia, however all relatives are given a copy of the homes complaints procedure and a copy of this procedure is displayed on the notice board at the home and this contained all of the required information and gave details of how to contact the CSCI. Staff members spoken to were also aware of the complaints procedure. Staff at the home has received training on adult protection as part of their induction and the home has a whistle blowing policy and also a copy of the Hampshire Adult Protection procedure. Staff spoken to know what to do should they suspect any form of abuse or poor practice had taken place Park House Rest Home DS0000062008.V305520.R02.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is “good”. This judgement has been made using available evidence including a visit to the service. In general service users live in a safe and well-maintained environment, however some areas of the home were in need of decoration. A great deal of refurbishment work is continuing in the home and this will improve the environment for service users. EVIDENCE: The home is continuing its programme of refurbishment and the rear garden has now been completely landscaped and this provides a pleasant secure environment where service users can wander around the garden and enjoy the flowers and shrubs, there is a sitting area with shade and raised flower beds. Two new single en-suite bedrooms have been added using existing rooms at the top of the house and a stair lift has been installed to provide access. A tour of the building was undertaken and communal areas were well lit and all areas were furnished, however the lounge/dining area was in need of Park House Rest Home DS0000062008.V305520.R02.S.doc Version 5.2 Page 16 redecoration and the inspector was informed that the lounge/dining area will be completely refurbished shortly and new furniture is being purchased, it is expected that this work will be completed in 6-8 weeks time. The home has two stair lifts and call systems are in place for service users to summon assistance. The home has a laundry and staff at the home carry out laundry duties, the laundry is equipped with 1 industrial washing machine and an industrial tumble drier, there is also a domestic washing machine, which is used to wash dining and kitchen linen. Staff at the home has undertaken infection control training and protective clothing is available for staff where appropriate. Park House Rest Home DS0000062008.V305520.R02.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is “good”. This judgement has been made using available evidence including a visit to the service. The home has a mix of staff that has a range of skills and there were sufficient numbers of staff on duty to meet the needs of service users. Staff morale was good and service users benefit from a staff team that has had sufficient training to meet the needs of service users. The homes recruitment policy and practice generally supports and protects service users, however not all of the required staff recruitment records were available at the home and this issue needs to be addressed by the home EVIDENCE: The homes rota showed that there is a minimum of 2 care staff on duty between 0800 and 2200, and between 2200 and 0800, one member of staff is awake with a sleep in member of staff available at the home to provide support if required, this is in addition to the homes manager who works flexible shifts at the home and also the provider who regularly works at the home. Care staff are supported by dedicated domestic staff that carry out cooking and cleaning duties. The inspector was informed that staffing levels are kept under constant review. Recruitment records were inspected for 3 members of staff and records contained most of the required information, including CRB checks and POVA checks where appropriate, however records for one staff member did not Park House Rest Home DS0000062008.V305520.R02.S.doc Version 5.2 Page 18 contain all of the required information (no copy of Passport or birth certificate) and it is a requirement that the home must keep all of the information required in schedule 2 of the care home regulations. Staff training records showed that staff have completed training in, fire, medication, moving and handling, first aid, adult protection, food hygiene, infection control, dementia care, managing aggression and challenging behaviour. Staff spoken to confirmed that they receive regular training and they were confident that they could meet the needs of service users. The home has an induction procedure provided by a local college and this covers care practice and principles of care. There is also an in house induction to cover procedures within the home. Park House Rest Home DS0000062008.V305520.R02.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is “Good”. This judgement has been made using available evidence including a visit to the service. Service users benefit from the ethos, leadership and management approach of the home and service users financial interests are protected by the homes policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. EVIDENCE: The manager has been at the home for over 4 years and has been employed as the manager for the past 2 years, she has completed NVQ4 and the registered managers award, however she was not available on the day of the inspection. Park House Rest Home DS0000062008.V305520.R02.S.doc Version 5.2 Page 20 The home has developed a questionnaire to give to service users and any visitors to the home and they also speak directly to relatives to ascertain how the home is meeting its aims and objectives. The home is also looking to publish a newsletter to relatives to inform them of the progress being made with the refurbishment of the home, there was also has a number of cards and letters from satisfied relatives. Service are not able to control their own finances and relatives deal with their financial affairs, however the home keeps some money for service users for hairdressing, chiropody and for any toiletries or personal items and appropriate records and receipts are kept. The inspector checked the balance for 3 service users and these were found to be correct. Certificates for the annual tests of fire fighting equipment, fire alarms, gas appliances, stair lifts and electrical equipment were all in date. The fire log was inspected and all relevant training and testing is carried out within the specified timescales. Park House Rest Home DS0000062008.V305520.R02.S.doc Version 5.2 Page 21 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 X 3 X X 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Park House Rest Home DS0000062008.V305520.R02.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP7 Regulation 15 Requirement It is a requirement that the home must improve the daily and monthly recording procedures in the home to provide clear evidence of care delivery It is a requirement that all of the information required in schedule 2 of the care home regulations must be kept at the home Timescale for action 25/11/06 2 OP29 17(b)(i) 25/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP12 Good Practice Recommendations It is recommended that the home keeps and activities book so that a record can be kept of the activities provided at the home and also of who did or did not take part. Park House Rest Home DS0000062008.V305520.R02.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Rest Home DS0000062008.V305520.R02.S.doc Version 5.2 Page 24 - 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!