CARE HOMES FOR OLDER PEOPLE
Park House Rest Home 220 Havant Road Hayling Island Hampshire PO11 0LN Lead Inspector
Michael Gough Unannounced 9 August 2005 - 11:00am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Park House Rest Home H54 S62008 Park House Rest Home V234024 090805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Park House Rest Home Address 220 Havant Road Hayling Island Hampshire PO11 0LN 023 9273 0613 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ms Sally-Jayne Hoke Miss Georgina Mitton CRH 14 Category(ies) of DE - DE Dementia (3) registration, with number DE(E) - DE(E) Dementia - over 65 (14) of places MD - Mental Disorder (3) Park House Rest Home H54 S62008 Park House Rest Home V234024 090805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users in the category DE may only be admitted over 65 years of age. Date of last inspection 4 November 2004 Brief Description of the Service: Park House is a detached residential care home situated within it’s 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 14 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 seafrom 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. Park House Rest Home H54 S62008 Park House Rest Home V234024 090805 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over 4 hours and was unannounced. The inspector was assisted by both of the registered providers and also the homes manager. Evidence for this report was obtained by speaking with the providers and manager, from reading and inspecting records, touring the home and from observing the interaction between staff and service users. It was also possible to speak with 4 service users and also 3 members of staff. What the service does well: What has improved since the last inspection?
The home has gone through some major changes since the last inspection to improve the outward appearance of the home and also improve standards of decoration within the home and 7 of the service users rooms have been decorated to a high standard and the front of the home has been transformed. A large high boundary wall has been taken down and the driveway has been covered with gravel, hanging baskets and pleasant flower borders have been planted to give the property a homely feel as visitors approach. All requirements and recommendations made at the last inspection have been addressed and service users have all been issued with new contracts and terms and conditions are clearly laid out. Care plans have been developed to a high standards and the medication cupboard at the home had been cleared of any unwanted items, which have been returned to the pharmacist. Clear procedures have been put in place for the safeguarding of service users financial arrangements within the home. Records of personal possessions brought into the home are kept and the home has successfully applied to the local council to have a large tree removed from the North end of the property, which was restricting light into some service users rooms.
Park House Rest Home H54 S62008 Park House Rest Home V234024 090805 Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Park House Rest Home H54 S62008 Park House Rest Home V234024 090805 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Park House Rest Home H54 S62008 Park House Rest Home V234024 090805 Stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3 & 6 Each service user has a written contract/statement of terms and conditions with the home. No service user is admitted to the home without first having his/her needs assessed and been assured that their needs can be met by the home. EVIDENCE: Service users are given a copy of their contract and this includes the terms and conditions of the home, this included the room to be occupied, overall care and service covered by the fees, information on what is not covered by the fees and also fees payable and by whom. The home has unfortunately had to terminate the contract of 1 service user and appropriate notice was given to the service user and her family. The registered provider or manager carries out an individual needs assessment prior to service users moving into the home and care files contained completed assessment forms, service users who are funded by social services also have an assessment carried out by the funding authority. Intermediate care is not provided by the home. Park House Rest Home H54 S62008 Park House Rest Home V234024 090805 Stage 4.doc Version 1.30 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 9 Service users health, personal and social care needs are set out in a plan of care and health care needs are generally met, however 2 service users are diabetic and these service users need to be informed of the availability of NHS podiatry services. The receipt, storage and administration of medication is satisfactory and the requirement made at the last inspection has been addressed. EVIDENCE: All of the service users spoken to were entirely satisfied the care that they are receiving and stated that their health care needs are met. Care plans were seen for 2 service users and these were simple and easy to follow, they gave information on personal and social care needs and care plans are reviewed monthly and annual reviews are undertaken. All of the service users are registered with a local GP practice on Hayling Island, although they are free to choose their own doctor. 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. A local chiropodist visits every 6 weeks and all of the service users take advantage of this service. There are 2 service users at the home who are diabetic and it is a
Park House Rest Home H54 S62008 Park House Rest Home V234024 090805 Stage 4.doc Version 1.30 Page 10 requirement that those service users who are diabetic must be made aware of the free treatment available through the NHS and if they choose to use the visiting chiropodist they should sign to acknowledge that they are aware of the availability of free treatment from the NHS with regard to foot care. The home has a policy for the receipt, storage, return and administration of medication and all staff at the home has undertaken training with regard to medication. Medication records sheets were inspected and found to be up to date and correct. Park House Rest Home H54 S62008 Park House Rest Home V234024 090805 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13 & 14 Service users are able to exercise choice and control over their lives and visitors are always welcome and there are no set visiting times. EVIDENCE: Service users spoken to stated that they were able to exercise their own choice and have control over their own lives as much as possible and staff were observed offering choice. Service users are encouraged to bring in their own personal possessions into the home and service users confirmed this and it was also possible to observe items in service users rooms. The home has a visiting policy and all visitors are required to sign the visitor’s book and it was possible to see that there is a regular stream of visitors to the home at varying times, the home respects service users wishes on whom they do or do not wish to see. Park House Rest Home H54 S62008 Park House Rest Home V234024 090805 Stage 4.doc Version 1.30 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 There is a simple, clear and accessible complaints procedure, which includes timescales for the process and any complaints are logged and responded to appropriately. EVIDENCE: Service users spoken to were confident about raising any concerns they may have and stated that they would address any complaint they may have to a staff member or to the homes manager. The home has a policy and procedure for dealing with any complaints and this contained all of the required information and gave details of how to contact the CSCI. Staff members spoken to were aware of the complaints procedure Park House Rest Home H54 S62008 Park House Rest Home V234024 090805 Stage 4.doc Version 1.30 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 22, 24, 25 & 26 Service users live in a safe, well-maintained environment and have access to safe and comfortable indoor and outdoor communal facilities. There is specialist equipment to maximise service users independence and service users rooms are safe and comfortable with their own possessions around them and the home is clean, pleasant and hygienic. EVIDENCE: The home is currently undergoing complete refurbishment and this is being carried out sympathetically as not to disturb service users, to date 7 of the service users rooms have been decorated to a high standard and the front of the home has been covered with gravel, hanging baskets and pleasant flower borders have been planted to give the property a homely feel. A tour of the building was undertaken and communal areas were well lit and the lounge/dining area was comfortable, with suitable furnishings. All of the service users individual rooms visited had been personalised and contained the required furniture and fittings. There is a stair lift to the first floor and
Park House Rest Home H54 S62008 Park House Rest Home V234024 090805 Stage 4.doc Version 1.30 Page 14 appropriate grab rails are situated around the home, there is a call system in the home and call bells are accessible for service users. The utility room at the home has been fitted with a new washing machine and a new tumble drier and the washing machine is able to wash clothing at appropriate temperatures. There was a clear laid down procedure for washing soiled items and there was also clear information for staff for the washing and cleaning of commodes. There is a contract for dealing with clinical waste and suitable protective clothing is available for staff, the home was seen to be clean and well maintained and there were no offensive odours. All staff at the home has received training with regard to infection control. Park House Rest Home H54 S62008 Park House Rest Home V234024 090805 Stage 4.doc Version 1.30 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 & 30 Service users benefit from a staff team that has had sufficient training to meet their needs and are competent and qualified. The home was commended for the training that it provides for its staff. The homes recruitment policy and practice generally supports service users, however information required to be kept in the home in respect of each staff member did not contain all of the information and a requirement was made for all required information to be kept in order to fully protect service users. EVIDENCE: The home is committed to proving good effective training for its care staff and the inspector commended the home for the training programme it provides. Training is provided through a range of distance learning courses and these courses include visits from tutors and also formal training courses. Staff training records showed that staff has completed training in Health and Safety, fire, medication, equal opportunities, moving and handling, 1st aid, adult protection, food hygiene, dementia care, aggression, person centred care, incontinence, use of hoists, risk assessment, infection control, nutrition, slips, trips & falls and a course on developing activities. Staff spoken to confirmed that they had received this training and stated that their induction training was comprehensive and they were confident that they could meet the needs of service users. Park House Rest Home H54 S62008 Park House Rest Home V234024 090805 Stage 4.doc Version 1.30 Page 16 The home has policies and procedures in place with regard to recruitment and staff recruitment records were inspected for 3 staff members and those seen did not all contain photographs and one had only one reference, it is a requirement that staff records must contain all of the information contained in schedule 2 of the regulations. Park House Rest Home H54 S62008 Park House Rest Home V234024 090805 Stage 4.doc Version 1.30 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 35 & 38 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: Service users are not able to control their own finances, and these are dealt with by relatives, however the home does keep money for service users day to day spending and appropriate records and receipts are kept, the inspector checked the balances of 3 services users and these were found to be correct. Regular staff meetings are held and minuets are kept, service users are consulted on a one to one basis, friends and relatives are consulted on an opportunity basis. Certificates were seen for annual tests of fire fighting equipment, fire alarms, boilers, and electrical equipment and for the stair lift and these 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 H54 S62008 Park House Rest Home V234024 090805 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x
COMPLAINTS AND PROTECTION 3 3 x 3 x 3 3 3 STAFFING Standard No Score 27 x 28 x 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x 3 x x 3 x x 3 Park House Rest Home H54 S62008 Park House Rest Home V234024 090805 Stage 4.doc Version 1.30 Page 19 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 8 Regulation 13 Requirement It is a requirement that those service users who are diabetic must be made aware of the free treatment available through the NHS. It is a requirement that staff records must contain all of the information contained in schedule 2 of the regulations. Timescale for action 10/10/05 2. 29 19 10/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Park House Rest Home H54 S62008 Park House Rest Home V234024 090805 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton Hampshire SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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