Inspection on 04/02/08 for Park House Rest Home

This inspection was carried out on 4th February 2008.

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.

Other inspections for this house

Park House Rest Home 18/12/08

Park House Rest Home 14/09/06

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 Val Sevier Unannounced Inspection 09:35 4 February 2008 th 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.V356998.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. Park House Rest Home DS0000062008.V356998.R01.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 465274 02392 765274 Ms Sally-Jayne Hoke Mr Lee John Gosling Miss Georgina Mitton Care Home 16 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (16), Mental disorder, excluding learning of places disability or dementia (3), Old age, not falling within any other category (16) Park House Rest Home DS0000062008.V356998.R01.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. 14th September 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 8 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 £395 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.V356998.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service 1 star. This means the people that use this service experience adequate quality outcomes. The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. The findings of this report are based on several different sources of evidence. These included: the Annual Quality Assurance Assessment (AQAA) completed by the home, and an unannounced visit to the home, which was carried out on the 4th February 2008. During the visit we looked around the inside and outside of the home, which included a sample of bedrooms and bathrooms. Staff and care records were sampled and in addition to speaking with staff and people who use the service, relatives and nurses, their day-to-day interaction was observed. We did this using an inspection tool called Short Observation Framework for Inspection (SOFI), and this is referred to in the report. All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the Commission for Social Care Inspection. What the service does well: The home welcomes people who will use the service and their families or representatives, to visit the home and look at the facilities of the home. The manager seeks information from external healthcare professionals as part of the assessment where necessary, to ensure that the home is able to meet assessed needs. Staff treat people who live at the home with respect; they share their companionship and give support sensitively. Health care was promoted through the home having developed good working relationships with healthcare specialists. Daily routines in the home were flexible and people who use the service being encouraged to make choices for themselves and exercise personal autonomy as far as was reasonably possible. Park House Rest Home DS0000062008.V356998.R01.S.doc Version 5.2 Page 6 People who live at the home were positive about the food that the home provided and were pleased with the activities in which they could participate and the condition of the accommodation that they occupied. People at the home, relatives and staff had confidence in the effectiveness of the home’s manager. Where systems and procedures were in place in the home they worked well including, dealing with complaints and health and safety. 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. The summary of this inspection report can be made available in other formats on request. Park House Rest Home DS0000062008.V356998.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 Park House Rest Home DS0000062008.V356998.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use the service can feel assured that their needs will be assessed and that the home has an understanding of their needs using the assessment process. EVIDENCE: We received the AQAA for the home, which stated: “As registered providers we personally carry out an individual needs assessment prior to clients moving to the home. A thorough assessment form is used to obtain as much information as possible from clients, family, representatives, social workers and hospital staff. On admission to the home the manager and head of care make a further assessment usually for a further 2-3 weeks, during the “settling in period”. We are further assisted by social services that also carry out a needs assessment for their client. These are held at the home on client’s care files. Park House Rest Home DS0000062008.V356998.R01.S.doc Version 5.2 Page 9 Admission Assessments are always carried out very promptly to avoid unnecessary delays, with decisions and feedback given usually the same day. We consult and involve all parties in these assessments and value any input, concerns and information received. Perspective clients are further invited with their families to come for trial days, lunches or activities before deciding to come to the home”. This was supported by evidence in the records of three care plans that we saw at the time of the visit to the home, and with talking with relatives of individuals who had moved to the home in the last year. The assessment includes the following areas: personal hygiene and dressing; safe environment; eating and drinking and swallowing; working and leisure; sleeping and aids to ability. It was also noted that there was information gathered from others who are involved in caring and supporting the individual, including the family and other health professionals. Park House Rest Home DS0000062008.V356998.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 9 &10 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people using the service would benefit from staff having more information in the care plans on how they could support individual needs The current practice for administering medication is outdated and unsafe and places the people who use the service at risk. Some staff working practice helped to ensure that the privacy and dignity of people who use the service is promoted. EVIDENCE: The AQAA returned to us by the home stated that: “On admission the health, personal and social needs of the client are set out in a thorough, individual care plan. These care plans are easy to read/follow and provide staff and health professionals with relevant information and history. Daily care records are maintained, in particular food/fluid charts, GP visits etc. Reviews are done weekly by the homes manager or sooner if needs change. The home ensures that clients have access to all necessary health care Park House Rest Home DS0000062008.V356998.R01.S.doc Version 5.2 Page 11 professionals and also provides transport and accompaniment to out side health appointments. Clients may choose their own GP or the home will register them with the local Hayling surgery. There is a visiting optician and chiropodist attends every 6 weeks”. On the day of the visit there were 13 people living at the home with two in hospital. We looked at three care plans for people that had come to the home since the last inspection visit. There were risk assessments for assisting with moving and handling and other individual issues for example the bedroom. The care plans had two separate sheets one had abilities; problems/needs; aims of care and method. An example for one individual for washing and bathing was: “does try but needs supervising, needs total help bath time. Aims of care were: to help keep clean and keep dignity; method was to encourage her to keep…” this was unfinished. The second part of the care plan was called ‘Individual care plan action sheet’. This had areas to write symptoms and action. Examples of the action for staff to assist were. Symptom: shows antisocial behaviour. Action: does hit out at residents and staff. Have to try and talk to her she is very confused. A requirement for action from the last visit was made regarding the keeping of daily notes. It was seen that the home do this and that these notes are reviewed and evaluated monthly or as needed by the manager. It was also seen on two of the care plans that there is a grid with monthly reviews on it, when asked the manager stated that this is another tool the home use which is currently under review by the manager and registered provider. It was seen in the care plans that physical health needs are also addressed with recent residents having moved to the home with information from health and other specialists; this information has been incorporated into the care plan at this home. It was also seen that residents have access to opticians and dentists as needed. Notes regarding physical health indicated that other professionals had been involved as necessary for example regular visits from the community psychiatric nurses to assist the home in caring for the needs of those individuals with dementia. A district nurse visited on the day of our visit and was heard to offer to attend to an individual in the lounge the care staff at the home asked that this should be done in the individual’s room. Two members of staff from a local crises team visited an individual who was at the home on respite following a fall, they felt welcomed and that the home was supporting the individual as well as they could although the individual was a little bored. The AQAA from the home stated that the” Clients at Park House (EMI) are Park House Rest Home DS0000062008.V356998.R01.S.doc Version 5.2 Page 12 protected by the homes policies and procedures for dealing with medicines. Assistance is always given by trained staff to aid clients with taking medication. The home has three policies regarding medication, which were shown to us by the manager, self-medication, refusal of medication and disposal of medication. The pharmacist visits the home as necessary, to offer advice, dispose of unwanted medication and take returns. Since the visit to the home the registered provider has sent us copies of all the medication policies used by the home that were not seen on the day of the visit. Medication is supplied to the home in a monitored dosage system. Medication is then transferred from this original pharmacy supplied and labelled container and placed by a member of staff, into another container for administration by another carer. This practice is not in line with best practice as described in ‘The Handing of Medicines in Social Care’, produced by The Royal Pharmaceutical Society of Great Britain. This practice was also described as frequently associated with medication errors in a report by the Department of Health, ‘Building a safer NHS for patients’. On the day of the visit we observed that a tray of pots were given to care staff by the manager, the pots had lids and individual names written on them, the care staff then tipped the medication into their hand and passed the medication to the individual’s hand. For one person the care staff dropped the medication from their own hand in the process of passing, onto the floor, the medication was picked up, put back into the pot and then taken again into the care staff’s hand and passed to the individual. It was also seen that where an individual had refused a medication their pot, was handed to the cook who placed it on the side in the kitchen. When we looked at the Medication Administration Record (MAR) sheets we saw that the manager had signed to say she had given the medication although she had given it to care staff to hand out. The manager was in the kitchen whilst the medication was given. We also saw that there was no policy at the home on the administration of medication. There was no signature list of staff authorised to administer medication. The manager has attended training in administering medication and is the trainer for the staff. Since the visit the registered provider has sent us a list of staff that have been trained to administer medication. The medication storage cupboard is a metal cupboard in an area by the laundry opposite the back door to the garden. The key to the medication cupboard was seen to be kept in key safe on the wall next to the cupboard. The key for the key safe was in it, and there was a list of numbers to identify the keys. The Controlled Drugs were kept in a metal lockable box in the medication cupboard. The manager showed us the monitored dosage system, which she had taken the medication from and put into pots. Park House Rest Home DS0000062008.V356998.R01.S.doc Version 5.2 Page 13 The controlled drugs are also recorded in a controlled drugs book, it was seen that for one individual when stock came in the current stock was not added to the new medication, the stock then did not match the record. Since the visit to the home the registered provider has written to us and has said that they will record new stock coming into the home in a clear and obvious way. The staff do not currently record that they administer prescribed creams to individuals, although they are on the MAR sheets. The manager was advised about this. The manager was also advised of new guidelines on the CSCI website regarding medication and the Royal Pharmaceutical Guidelines. We were able to observe the interaction between the staff and people who use the service using the SOFI tool; we were also able to speak with some individuals and two relatives on the day. The two relatives spoken with were happy with the care provided to their relative at the home, one commented that their parent had improved and felt that this was due to the care, food and the liaison between the home and health. One individual living at the home commented that staff were kind and gentle, there were no complaints about the food and there were books to read, however for them there was not enough to do. The SOFI tool, which was used for two hours, indicated that the staff generally supported people who use the service. Staff were observed speaking and assisting the residents with dignity and respect. It had been seen on care plans that the preferred choice of name had been recorded and staff were heard to speak to residents by the name they wished. Park House Rest Home DS0000062008.V356998.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service participate in activities appropriate to their age, peer group and cultural beliefs as part of the local community. Dietary needs are well catered for with a balance and varied selection of food available that meets individual dietary requirements and choices. EVIDENCE: The lounge / diner is divided by using the chairs so there is a sense of two areas. There is a television in one corner which not all people can see depending on where they sit. On the day of the visit the staff asked if people would like music on and a musical film was chosen several people were seen and heard singing along and one visitor spoke to their relative about the film, music and costumes. We used the SOFI tool between 10:45 and 12:45, which was the period before lunch and lunchtime. The interaction between the staff and residents was in the main task orientated, ‘would you like a drink, would you like a biscuit’, and in assisting people to use the bathroom. It was noted that the room was very Park House Rest Home DS0000062008.V356998.R01.S.doc Version 5.2 Page 15 quiet with three of the four people observed going to sleep when there were no staff in the room. The manager showed us the record of activities that take place and there is usually something each day such as chair exercise, aromatherapy, music for health, keyboard and singing, card games, hand massage and Reiki. One individual was seen out in the garden with a member of staff after lunch helping with the laundry. The home has a four-week menu; no choice was seen on it. We asked the manager how choice is offered and she stated that staff go round and speak to the residents and say what is for the meal, if they say they do not like it then they talk about what the person would like and they have that. The amount people eat and their changes in likes and dislikes, is monitored to assist with the menu planning and health care. We observed the lunchtime and saw that there was for most of the time one member of staff in the room, their time was divided between supporting one person to eat, and giving meals and medication out. The second care staff person came in briefly then went to feed someone in their room. The domestic helped in the beginning with giving out meals and drinks then continued with their job. It was seen that the individual being assisted in the lounge was sometimes out paced in their meal with the staff member giving the next spoonful whilst the individual still seemed to be eating. The meal given was in two bowlfuls however the meal was liquidised together for example the curry and vegetables were one soup like substance. This was discussed with the manager when we gave feedback on the SOFI and she stated that at the weekends when she cooks she liquidises each part of the meal separately. It is recommended that the way in which liquidised food is presented be reviewed. People who were able to comment said that they liked they food and there was always more than enough. Park House Rest Home DS0000062008.V356998.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are protected through the open complaints process and the staff’s knowledge and understanding of safeguarding and protection issues. EVIDENCE: There have been no complaints received by the home or the commission. The manager advised that the home promotes an open door approach to relatives and people who use the service, to help resolve complaints and issues effectively. The home uses Hampshire’s safeguarding adult policy and staff were seen to have had training in adult protection. This was seen to support the information given by the home in their AQAA. “Park House provides a simple, clear and accessible complaints procedure, which includes timescales for the process and any complaints are recorded and responded to appropriately. Park House protects clients from any form of abuse and would deal with any incidents robustly. The home provides a policy for dealing with complaints and this is held in the home and is accessible to all. The policy includes contact details for the CSCI. Staff receive training on induction about the complaints policy and whistle blowing policies. They are further trained in on these subjects during dementia care training. A copy of the Hampshire Adult Protection procedure is held at the home for all to access”. Park House Rest Home DS0000062008.V356998.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have a pleasant and homely environment to live in which also has had adaptations to meet individual needs. EVIDENCE: The manager showed us around the home and explained some of the changes that are to take place soon, for example the bathrooms will be altered as the home has a grant, it is hoped that these will be done by April 2008. The home has a lounge /diner which has been divided up using some of the lounge chairs giving the effect of two rooms. There are four dining tables enabling 20 people to be sat for meals and people can choose where they sit. All of the bedrooms seen were brightly decorated and had evidence of individual personalities with posters and the service users photographs on the Park House Rest Home DS0000062008.V356998.R01.S.doc Version 5.2 Page 18 walls, and other personal effects. People who live at the home are encouraged to furnish the room with personal belongings such as furniture and pictures, to make it feel like home. Consideration is given to the support of needs with the use of equipment. It was noted that in accordance with best practice all communal WCs that were seen were provided with liquid soap dispensers (that were full and working), alcohol gel sanitizers and paper towels. Protective clothing was readily available and staff were observed using gloves and aprons. The home’s laundry had washing machines and dryers and there were procedures in place for the management of soiled laundry items. The home manages all the laundry, which is done by the care staff. There was no malodour in the home and it was seen to be clean and tidy. This supported the AQAA sent by the home, which stated: “Ongoing refurbishments to update the home environment continue to be at the forefront of our intentions. Additions to the communal areas, gardens and facilities also continue. The lounge and dinning room has been extensively refurbished and now provides a wonderfully light, clean and comfortable area for all to enjoy. The two chair lifts in the home have been replaced with new models. The main bath hoist has been replaced with new equipment and additional moving/handling equipment is available to assist clients and staff. New laundry equipment has been purchased to now provide two extra washing machines and new freezers for the kitchen facilities. Staff are fully trained on many subjects including infection control. Personal protection equipment is available to use and the home has clear robust policies to ensure the home is clean and hygienic”. Park House Rest Home DS0000062008.V356998.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the services have their needs met by staff that are trained, supportive and sufficient in numbers. However the current recruitment practice of the service places people who use the service at risk. EVIDENCE: The staffing structure provides a broad spread of experience and professionalism: manager, care staff, kitchen staff, and housekeeping. Other health care professionals support the team from outside the home as needed. Staff spoken with on the day of inspection indicated that they were aware of the needs of the residents who live at the home; they also seemed enthusiastic about working at the home. There was evidence that staff have received training in all mandatory areas such as food hygiene, first aid and manual handling, health and safety, vulnerable adults, infection control, continence management, challenging behaviour and dementia. Staff receive at last three days training a year and are enabled to access courses either at the home or externally. The manager has recently been on a Mental Capacity Act training course and with the registered provider plans to cascade this information to all staff at the home. The manager has also been on a slips, trips and falls training course and is due to go with another member of staff to a follow up day in March 2008. Park House Rest Home DS0000062008.V356998.R01.S.doc Version 5.2 Page 20 Following the last inspection to the home a requirement was made regarding the information to be kept for the recruitment of staff. On this visit we sampled five staff files. For one member of staff who was working their second shift there was no paperwork regarding their recruitment. For another there was no application form or references. For two there were records of verbal references however these had not been followed up with written ones. For two staff their CRB and POVA checks were dated after their employment had began. Park House Rest Home DS0000062008.V356998.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service would benefit from improvements in management practices in the home including care planning, recruitment and medication, where systems and procedures need to be in place to promote the safety and welfare of those using the service. EVIDENCE: We were able to discuss the observations from the SOFI tool, the medication administration and recruitment with the registered manager at the time of the inspection. The manager has been at the home for over 5 years and has been employed as the manager for the past 3 years, she has completed the NVQ4 and the registered managers award. Ms Mitton was able to show that she has Park House Rest Home DS0000062008.V356998.R01.S.doc Version 5.2 Page 22 continued to update herself and the staff through attending training relevant to the needs of people living at the home. The manager stated that people who use the service and their relatives or representatives and the staff, are able to discus all aspects of the running of the home generally or on a personal level. However written evidence of a quality assurance system was not available on the day of the visit. The AQAA received from the home stated that: “As owners we speak directly to clients and their families to ascertain how the home is meeting its aims and their needs. The home keeps pocket monies for service users needs for example newspapers and hairdressing and records of all accounting. This is available for inspection at any time. Maintenance records are kept for all equipment, services and inspections within the home. Fire testing and safety checks are carried out within the required timescales”. We sampled the monies and records kept at the home and these were found to be accurate. It was noted that the home’s equipment, plant and systems were checked and serviced for example: passenger lift and hoists; fire safety equipment portable electrical equipment and the hot water system. There were contracts in place for the disposal of clinical and household waste. Records were kept of accidents. There was a fire risk assessment for the premises; tests of equipment and regular risk assessments of the premises and working practices were undertaken regularly. Park House Rest Home DS0000062008.V356998.R01.S.doc Version 5.2 Page 23 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 1 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 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 3 Park House Rest Home DS0000062008.V356998.R01.S.doc Version 5.2 Page 24 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 OP7 Regulation 15 Sch 3 Requirement The care plans must have the action and support that staff need to give to meet individual needs. In the interests of safe medication handling and to show that people who use the service get their medicines as prescribed you must: Give medicines directly from the original labelled container to people and not place medicines into any secondary container for administration by another carer. Keep complete and accurate records of all medicines given to people, including creams and controlled drugs. These must be made by the person who gives the medicines. Store medicines securely. Produce clear and comprehensive procedures for the receipt, recording, storage, safe handling and administration of medicines. The home must have a recruitment process with checks carried out, and in place before the person begins employment. DS0000062008.V356998.R01.S.doc Timescale for action 04/05/08 2 OP9 13 (2) 17/03/08 2. OP29 17(b)(i) 17/03/08 Park House Rest Home Version 5.2 Page 25 When these documents are obtained they must be kept at the home. This is partially repeated requirement from November 2006. 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 OP15 Good Practice Recommendations It is recommended that the way in which liquidised meals are presented to people be reviewed so that it appears appetising. Park House Rest Home DS0000062008.V356998.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V356998.R01.S.doc Version 5.2 Page 27 - 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!