Inspection on 11/12/06 for Park Lane Care Home

This inspection was carried out on 11th December 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 Lane Care Home 13/12/05

Park Lane Care Home 13/07/05

Park Lane Care Home 24/02/05

Park Lane Care Home 01/11/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Park Lane Care Home 45 Park Lane Barnstaple North Devon EX32 9AL Lead Inspector Ms Rachel Fleet Unannounced Inspection 11th December 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 Lane Care Home DS0000061234.V308887.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 Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park Lane Care Home Address 45 Park Lane Barnstaple North Devon EX32 9AL 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) 01271 373600 01271 329404 Waterfall Nursing Homes Limited Mrs Mavis J Eastaugh Care Home 27 Category(ies) of Dementia - over 65 years of age (25), Old age, registration, with number not falling within any other category (27) of places Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th December 2005 Brief Description of the Service: Park Lane Care Home is in the residential area of Newport on the outskirts of Barnstaple, being the only care home that provides nursing care in Barnstaple. The home is registered to provide care with nursing for 27 people over retirement age, including care for up to 25 people whose nursing care needs are due to dementia. Dementia care is a new service offered by the home, largely intended to ensure the home can meet changing needs of existing residents. The manager does not currently intend to admit anyone with advanced dementia, partly because the environment is not fully adapted to meet the needs of such a client group. The home accepts people who are referred by the Primary Care Trust’s ‘Rapid response’ team because they need immediate admission to a care setting due to some emergency. The home also offers day care, including these service users within the total of 27 people who can be cared for under the terms of the home’s registration. Day care is not regulated by CSCI. The home previously consisted of two detached houses that have been connected to make one. It is situated in its own grounds, consisting of lawns, trees and flowerbeds. There is a wheelchair-accessible entrance, as well as an entrance from the parking area at the front of the building. Local shops and facilities are within walking distance. The home stands on three floors, with two passenger lifts providing access to all areas. Where there were steps in corridors, these have been replaced by sloping floors, to facilitate access around the home. Most bedrooms are for single occupancy only, but shared rooms are also available if required. Televisions are provided in all bedrooms. All but six rooms have en suite facilities, with two en suites having a shower. Rooms without en suites have a hand basin, and are near to toilet or bathroom facilities. There are four sitting areas, including a library room upstairs, and a dining room. The home changed ownership on 1st June 2004 and is now owned by Waterfall Nursing Homes Limited. Since the change of ownership, the home has been Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 5 transformed in appearance by significant improvement, updating and modernisation in order to meet and exceed, in some areas, the national minimum standards. This includes four new bedrooms currently being built. Weekly fees at the time of the inspection were £481 - £650. These did not include the costs of chiropody (£9.50), or hairdressing, newspapers, toiletries, and trips out (including some transport costs) - which are at cost price. Inspection reports produced by the Commission for Social Care Inspection (CSCI) about the home are available in the inner reception area of the home (in a drawer beneath the Visitors’ book), from the manager’s office, or from the Commission’s website. Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. There were 18 residents at the home on the day of this unannounced inspection, as well as someone attending for day care. Mrs Mavis Eastaugh, home manager/matron, had returned a CSCI pre-inspection questionnaire. Completed CSCI surveys or comment cards were returned from three residents (of five sent out, two being anonymous), four care staff (of eight sent out, three being anonymous), and four community-based health or social care professionals (of ten sent out). All these surveys were returned in September and October 2006, when there was a higher occupancy at the home, and before the home was registered to provide dementia care. This had to be born in mind when responses were used to inform this inspection. The inspector Rachel Fleet met at least seven residents individually around the home, as well as observing general care of others who were sitting together in communal areas. A number were too physically or mentally frail to give their views verbally in any depth. The inspection incorporated ‘case-tracking’ of three residents, including new residents and those with dementia. This involved looking into their care in more detail - by meeting with them, checking their care records and other related documentation (pre-admission assessments, medication sheets, etc.), observing care they received, talking with their visitors in some cases, and with staff, as well as looking at their bedrooms. The inspector spoke with four visiting relatives, a visiting professional, seven members of the nursing, care and ancillary staff – all of whom were positive about the home. The manager also assisted through the inspection. Other records seen included those relating to staff, residents’ personal monies, the kitchen, health and safety, and quality assurance. A tour of the building included the kitchen and laundry. The Commission has had contact regarding concerns about the home, from one person anonymously, since the last inspection. These were about effects of the building work at the home, with reports of dust, coldness and problems with the hot water supply affecting residents and staff. The manager was informed of these concerns, and they were followed up during this unannounced inspection. The inspection was carried out in nine hours over two days, the findings then being discussed with the manager, deputy manager, and Responsible Individual Mr Peter Barden. Information gained from all these sources and from communication with the service since the last inspection is included in this report. Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? What they could do better: Updating information about the home and making it more accessible both in format and availability would promote residents’ right to choice and control in their lives. These rights could also be more fully promoted in various other ways. Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 8 Aspects of medication management could be improved, to promote safer systems. Recruitment is a very considered process, but all required information has to be obtained before employing any new staff, to help ensure residents are protected from unsuitable carers. Staff have training and support, but ensuring all staff have training on dementia would help to make certain that residents’ changing needs are met, with the home able to provide the specialist services it offers. 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 Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 9 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 Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 10 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): 1 – 3. (The home does not offer intermediate care). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Adequate information about the home is available to prospective residents, to help them decide if it is suitable for them, but aspects need improvement to provide more accurate and more accessible information. Good systems are used to assess potential residents’ requirements, thus ensuring that the home can meet individuals’ needs if they do move in. Written contracts are routinely provided, with good clarification of the service agreed with each resident and promotion of their rights. EVIDENCE: The home’s brochure is being updated to reflect recent changes at the home, and will soon be available again. The Statement of Purpose and Service user guide are available for prospective residents visiting the home and for existing Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 11 residents, from the office. These explain what can be expected of the home, helping people decide which is a suitable home for them to move into, for example. Individual copies are not currently provided for people to keep, and the copies available are in a standard format, thus prospective residents may have limited access to the information. And the information needs updating, to include the dementia care service offered by the home, and information about nursing care fees, for example. No residents or visitors asked could recall seeing information about the home before the resident went to live there, although most had looked around. But some residents had been emergency admissions – moving in without opportunity to choose a home - or relatives had dealt with admission arrangements, so they may have seen the information. Signed ‘terms and conditions’ of admission were seen, in office-held files, for case-tracked residents. Two relatives confirmed they had received a copy on behalf of two residents. The manager confirmed all residents have these, prepared for completion on the day of admission - as reflected in those seen. They included the information listed in the relevant National Minimum Standards, including how notice would be given of any increase in fees. Informative pre-admission assessments of prospective residents’ needs were seen, carried out by the deputy manager, with information from their then carers also, in some cases. One resident said they’d met with senior staff when they came to look around, their family having given information about their needs already. Details had been used as a basis for initial care plans for each resident. The manager said community-based professionals usually fax information to the home about emergency admissions, when there is no time for the home’s staff to meet the person concerned ahead of their arrival. Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 12 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 – 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health and social needs are recorded, giving staff good information on how to meet residents’ various needs. Regular reassessment and multidisciplinary working ensures residents receive good health care. Management of medication is adequate, but certain aspects should be addressed to promote safer systems. There is good promotion of dignity, and respect for residents, promoting their rights. EVIDENCE: Very clear, personalised care plans were seen for each resident, with regular reviews carried out to ensure they were up-to-date. Staff explanations of care they gave corresponded with information in these. Social histories were Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 13 generally kept separately, being drawn up by the activities staff. However, care staff spoken with were aware of residents’ past employment, interests, etc. Two care plans needed additional information about what pressure-relieving equipment was being used, although care plans were otherwise in place to promote healthy skin. Residents asked could not recall being involved in the drawing up of their care plan, and there was no other evidence of this, to show care has been agreed with them. Residents and relatives asked felt staff were observant of residents’ general health, and acted promptly, including contacting the GP if needed. One resident’s care records showed the GP had been contacted about their weight loss. CSCI surveys completed by GPs said the home communicated clearly and worked in partnership with them. Wound care plans and evaluations were clear, detailed and up-to-date, as were care plans for residents with diabetes. The latter included contact details for community-based professionals (diabetic nurse specialists, etc.), so staff could easily get other assistance if needed. A physiotherapist had visited one resident, to advise on their mobility. Staff responded in a kindly way to residents showing confusion; a resident with dementia was left to walk about, seemingly content, once staff had discretely established there was no particular place they needed assistance to find. A visitor said their relative (who had dementia) had improved since admission, as also reflected in care records and conversations with staff. All beds are height-adjustable nursing beds, with a type of specialist mattress used on all to reduce risk of pressure sores. The home’s contract currently indicates that the home will generally be responsible for all residents’ medication. However, senior staff intend to look at what support individual residents need, so that they can remain in control of their own medication as much as possible. Medications were kept in locked facilities, including a fridge for items needing cold storage. Individual stock was available where checked against administration sheets for case-tracked residents. Medication received into the home was recorded on these sheets with separate records seen for items disposed of, providing an audit trail. One, for a new resident, was handwritten but had not been signed and dated by two staff, to verify the accuracy of entries. Stocks of two controlled drugs had not been needed for over a month but had not been disposed of yet. One resident was allergic to a medication, as noted in their care plan. However, this had not been noted on their medication records, and the nurse spoken with was not aware of it. Senior staff confirmed this was an oversight, and said it would be noted accordingly, to prevent prescribing errors. Residents felt staff ensured their privacy. Their preferred name was included on care records, and used by staff, as noted during the inspection. Staff were heard explaining to residents what they were about to do, when giving care. A resident and two visitors said staff were gentle when handling residents, as seen during the inspection. Privacy signs were used on bedroom doors, as confirmed by two residents and seen during the inspection, so people were not Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 14 disturbed during personal care. Shared toilets and bathrooms had appropriate locks. There were curtains between beds in shared rooms, to give some privacy. GPs confirmed they could see residents in private. Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 15 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 – 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is good provision for social fulfilment, with recent developments beginning to improve individual residents’ quality of life. There are good links with residents’ families, friends and the community around the home, helping to ensure residents benefit from various supportive and interesting relationships. Residents have adequate choice and control in their lives, but some additional measures would ensure these rights were more fully supported. There are good catering arrangements that meet residents’ tastes, as well as their social and health needs. EVIDENCE: Residents asked felt there was enough for them to do with their time, having their own interests or joining planned group activities. One was looking forward Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 16 to going to a Christmas lunch at a local hotel, with others from the home. Bingo, a quiz and an exercise class took place during the inspection, with the activities co-ordinator. A visitor said if someone wants to go out in an evening, the home arranges it. The activities co-ordinator has just begun to accept ‘challenges’ – taking a resident to certain musical events they wanted to attend, despite the resident’s health needs, and now being asked to arrange a trip to horseracing for certain residents. Frailer residents were dozing during the inspection, staff being occupied with physical care of residents most of the time. The activities co-ordinator has attended dementia care training, and hopes to improve the activities programme to ensure the needs of residents with dementia are being met. Members of clergy from three denominations visit the home weekly, and hold church services - residents being informed of the dates in the home’s monthly newsletter seen. Two people said the home had a family atmosphere, one saying visitors were always offered a drink when they came. A visitor said they felt able to stay at the home as long as they wished. Another said they had meals there with their spouse (which they paid for), whilst a resident ate lunch with a friend during the inspection – in the privacy of a smaller dining-lounge. There are outings to places of interest, local pubs, etc., as well an entry in this year’s local carnival. It was noted that immobile residents in lounges did not have easy access to a call-bell, relying on able residents to use a wall-mounted call point on their behalf or calling out to people passing by; staff said people went by often so would notice if anyone wanted help, but during the inspection there were short periods when this did not happen. Lockable facilities are not routinely provided for individuals, although the responsible individual felt this could easily be arranged; having safe storage would give residents better options for keeping medicines, money or valuables rather than the home or others holding these. Minutes are not kept of residents’ meetings; non-attending residents therefore have less opportunity to be involved in the running of the home. See also Standards 1, 7 and 9. Although one survey respondent said they ‘sometimes’ liked the food provided, all other residents said the food was good or acceptable. Two choices are offered at lunch. One resident said they asked for a salad if they didn’t like either choice, and another said they had cheese and biscuits, which suited them. Staff offered plates of biscuits around on drinks rounds, promoting residents’ choice again. One resident said food had improved since a new cook had been employed. Food stocks included a variety of seasonings, popular brands, and fresh fruit and vegetables. There was a calm atmosphere at lunchtime. Some residents ate in the dining room, but others remained in their specialist seating in the lounge or ate in their rooms. Polite individual assistance was given as needed. A resident said their frailer peers always got help and this was ‘really well done’. A visitor said the home had provided a more suitable diet for a resident who was having swallowing difficulties. Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 17 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good response to complaints, ensuring they promote improvement of the service residents receive. There is a good range of safeguarding policies and practices in use, to try to protect residents from abuse. EVIDENCE: Residents and visitors asked said they felt able to make suggestions, raise concerns or complaints to staff, and that the home responded quickly. One said the manager’s door was always open. Another said the manager was very accommodating so there was no need to complain. None had a written copy of the complaints procedure, but it was displayed at the entrance to the home. The manager said different formats could be provided if necessary – larger print, audio versions, etc. The concerns and complaints log had a variety of topics noted, and included action taken by the home to resolve the issues. These included the concerns raised with the Commission anonymously, that the home had been notified of. These were followed up during the inspection areas occupied by residents were warm other than where a resident wanted their room cool; no dust was noted; there had, however, been problems with the hot water supplies, though now resolved. No residents or staff made any Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 18 complaints to the inspector, even when asked about the effect of current building work. Residents said they felt safe with staff. One added that the home had acted quickly when they brought up a matter at a resident’s meeting that they thought was affecting the welfare of another resident. Surveys from GPs said they thought staff took appropriate decisions when they can no longer manage the care needs of residents, suggesting residents are kept safe. An external trainer said they had been asked by the home for evidence of a police check, since they would be in contact with residents at the home. Staff asked and staff surveys confirmed they were aware of adult protection procedures, with two training sessions having taken place recently. There were good, plainly written policies about protecting residents from abuse and the use of restraint. The second suggested the GP should be consulted about use of potential restraints but did not suggest full multidisciplinary decision-making (mental health staff, physiotherapist, etc.), which would ensure the most appropriate decision was reached. The manager agreed to review this. Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 19 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Current residents benefit from a generally good, safe and homely environment, adapted to their needs. Systems are in place to promote good standards of hygiene, protecting residents’ wellbeing. EVIDENCE: Residents and relatives asked were satisfied with the accommodation. The home looked well maintained throughout, with much natural light. Residents and staff confirmed repairs are dealt with quickly. A new boiler has recently been fitted. The handyman was checking rooms during the inspection to ensure hot water was available, although he confirmed it took a little while to Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 20 reach some rooms. There were no complaints about the home being cold, although Mr Barden (the responsible person) asked for a radiator to be checked in a less used lounge that was cool during the inspection. Grab rails had been fitted where individual residents would benefit from them. There is an adapted shower facility, and bath hoists, to make access easier for disabled residents. The lifts have bright digital displays and Brail on the buttons, to help poorly sighted people using the lifts independently. The environment is generally suitable for current residents, but not yet well adapted for dementia care (in terms of use of colours, signage, etc. to promote residents’ independence). The manager said this would be improved, although she does not intend to admit anyone with advanced dementia. She also said handrails have not been fitted in corridors so no space is lost. The home was clean, with housekeeping staff at work most of the day. Residents asked were satisfied with standards of cleanliness in both private and shared areas. Care staff were seen to wear disposable aprons when assisting with meals. All bedrooms had liquid soap and paper towel dispensers, promoting good hand hygiene. Staff described appropriate methods to minimise cross-infection when handling soiled laundry, including use of appropriate washing machine programmes to thoroughly clean items. There are sluice facilities on each floor. Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 21 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): 27 – 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff numbers, the skill mix and basic level of knowledge and skills are good, helping to ensure residents’ needs can be met safely. Recruitment practices are adequate, although all required information must be obtained before employing staff in the home, to help ensure residents are protected from unsuitable staff. Training and support for staff is adequate, but would be improved by further training on dementia for all staff, to ensure residents’ changing needs will be met, with the home able to provide the specialist service it offers. EVIDENCE: Residents said the staff were ‘good’, ‘helpful’, and most said they were always around, answering call bells quickly day or night. One survey said staff were usually available when needed; one said they sometimes got the care and support they needed, although they said staff were always available. There was a nurse with three care assistants on duty initially during the inspection, besides the manager, cook and housekeeping team, looking after 19 people (including one attending for day care). This level of care staff was maintained Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 22 during the day apart from a period in the afternoon where there were only two care assistants. The activities assistant was also present for part of the time, as was a hairdresser. The Deputy manager, who works full time, has a mental health qualification and acts as the clinical advisor for the dementia care offered by the home. An assessor from a training company visited staff during the inspection, regarding nationally recognised care qualifications seven are undertaking or about to begin. The pre-inspection questionnaire showed almost half of care staff have a recognised care qualification already. And rotas confirmed there is always a nurse on duty, to supervise general nursing care. Three staff recruitment files were checked and generally included required information to ensure appropriate people are employed. All had relevant experience. A police check had not been requested for a new staff member who had one done for their then current job whilst applying to work at Park Lane care home. That check was satisfactory, and good references were obtained, including from their then employer. The manager confirmed every other staff member had had a police check done. Current guidance is that, for care workers, police checks are not portable between jobs, to ensure up-todate checks are done to protect residents from unsuitable people. Residents said staff knew what help they needed and were able to assist them as necessary. A care assistant confirmed they had had a yearly appraisal of their work performance, and the manager confirmed there is clinical supervision for nurses, as seen listed on the monthly training programme. Surveys also reflected supervision takes place. The pre-inspection questionnaire showed there had been updates on certain practical nursing skills. A small number of staff have attended training on dementia care, with more to attend; one staff member said it was very useful. A carer spoken with described aspects of care appropriately, although they had not yet attended the training. They also said they felt able to ask questions and seek advice from their nurse colleagues. Of the surveys completed by GPs, three said staff demonstrated clear understanding of residents’ care needs (one did not respond to this question); all four were satisfied with care overall. Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 23 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has a good level of knowledge, skills and experience, which ensures the home is generally run well. Good efforts are made to ensure the home is run in the best interests of the residents. Good practices used by the home protect residents’ financial affairs. There is good attention to health and safety matters, protecting residents and staff. Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 24 EVIDENCE: The Responsible Individual is clearly closely involved in the running of the home, as seen during the inspection. Residents, visitors and staff felt the manager Mrs. Eastaugh was approachable. She has several years of experience in managing nursing homes for the elderly. During the inspection she showed knowledge of relevant legislation (including some new regulations), which she had taken steps to address. And she has attended Social Services training on safeguarding or protection of vulnerable adults since the last inspection. Minutes were not available, but residents and relatives confirmed there were meetings held for them. They felt their views were listened to and action taken regarding suggestions. A survey on meals was carried out earlier this year, completed surveys being seen; the manager said findings had since been discussed at a residents’ meeting. There was evidence of service improvement since the last inspection – in training, development of the activities programme, and the environment, for example. The home does not act as appointee for any residents, leaving control of residents’ financial affairs to those chosen by or for the residents. Residents who had personal monies held by the home on their behalf had no concerns about how this was managed. Computerised records were seen, with receipts available when requested, for recorded transactions. Totals shown matched cash balances held individually for these residents. Receipts are also given to people handing money in to the home. Valuables can be safely stored by the home if a resident wishes it, although individual safe storage is not yet routinely available (see Standard 14). Housekeeping and care staff said they had attended manual handling training. They knew where to find safety information about cleaning chemicals, etc. that they used. Accident forms were completed well. It was seen action had been taken to prevent recurrences of some of the accidents – through warning signs, for example. The manager had put systems in place to meet new food regulations. Fridge and freezer temperatures were kept within appropriate ranges, according to records seen; food portions in fridges were covered and dated, ensuring they were safe to use. Radiators are guarded to prevent burns from hot surfaces. The manager said that since a new boiler was fitted recently, there is no stored water, minimising any risk of Legionella. The fire log showed whilst some fire safety checks were carried out, regular checks on fire extinguishers were not evident though recommended by the local fire authority. The manager said this would be addressed. Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 25 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 2 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 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 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 26 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 OP1 Regulation 4 Requirement (1) The registered person shall compile in relation to the care home a written statement - the statement of purpose) which shall consist of: (a) A statement of the aims and objectives of the care home; (b) a statement as to the facilities and services which are to be provided by the registered person for service users; and (c) a statement as to the matters listed in Schedule 1. (2) The registered person shall supply a copy of the statement of purpose to the Commission. This should include full, up-todate information about the service the home offers, including dementia care. Particularly, but not exclusively: (1) The registered person shall produce a written guide to the care home - “the service user’s guide” - which shall include: (a) A summary of the statement of purpose; (b) A description of the standard services offered by the care home to service users; DS0000061234.V308887.R01.S.doc Timescale for action 31/01/07 2. OP1 5 14/02/07 Park Lane Care Home Version 5.2 Page 27 (ba) the terms and conditions (other than those relating to fees) in respect of the provision to service users of accommodation (including the provision of food), personal care and (if available) nursing care; (bb) details of the total fee payable in respect of the services referred to in subparagraphs (b) and (ba) and the arrangements for the payment of such a fee; (bc) the arrangements in place for charging and paying for any services additional to those mentioned in sub-paragraphs (b) and (ba); (bd) a statement of whether any of the matters mentioned in subparagraphs (b) to (bc) would be different in circumstances where a service user’s care was being funded, in whole or in part, by a person other than the service user; (c) A standard form of contract for the provision of services and facilities by the registered provider to service users; (d) The most recent inspection report; (e) A summary of the complaints procedure established under regulation 22; (f) The address and telephone number of the Commission. (2) The registered person shall supply a copy of the service user’s guide to the Commission and each service user. 5A Information about fees: (2) The registered person shall provide to each person who becomes a service user on or after 1st September 2006, by Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 28 not later than the day on which he becomes a service user, a statement specifying— (a) The fees payable by or in respect of the service user for the provision to the service user of any of the following services— (i) Accommodation, including the provision of food; (ii) Nursing; and personal care, And, except where a single fee is payable for those services, the services to which each fee relates; (b) The method of payment of the fees and the person or persons by whom the fees are payable. (5) Where a nursing contribution is paid in respect of nursing provided at the care home to the service user, the registered person shall provide to the service user a statement specifying— (a) The date of payment and the amount of the nursing contribution; and (b) Either (i) the date (if any) on which the registered person is to pay the amount of the nursing contribution to the service user or deduct that amount from the fees referred to in paragraph (2)(a); or (ii) if the nursing contribution is not to be so paid or deducted, whether and if so how it is taken into account for the purpose of calculating those fees. 5B Existing service users: transitory provisions (1) For the purposes of this regulation, an existing service user is a service user who is accommodated in a care home Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 29 immediately prior to 1st September 2006. (2) Except where such information has already been provided, the registered person shall, no later than 1st October 2006— (a) Provide to each existing service user the information referred to in regulation 5A(2)(a) and (b); (b) Inform each existing service user as to whether a nursing contribution is paid in respect of nursing being provided to him at the care home; and (c) Where a nursing contribution is so paid, provide him with a statement specifying the information referred to in regulation 5A(5)(a) and (b), as modified in accordance with paragraph (3). 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 OP1 Good Practice Recommendations It is recommended that a) The registered person makes available to service users an up-to-date statement of purpose, and provides a service users’ guide to the home for current and prospective residents; b) The service user’s guide is made available in a language and/or format suitable for intended residents. This is to ensure information is easily accessible, promoting choice for prospective and existing service users. It is recommended that the registered person ensures that DS0000061234.V308887.R01.S.doc Version 5.2 Page 30 2 OP9 Park Lane Care Home 3 OP14 4 OP29 5 OP30 there are appropriate policies, and staff adhere to procedures, a) For the recording and disposal of medicines, especially regarding i) Handwritten entries on administration sheets, which two staff should sign & date entries, to verify their accuracy, & ii) Timely disposal of unwanted medications; b) So that service users are able to take responsibility for their own medication if they wish, within a risk management framework. It is recommended that the registered person conducts the home so as to maximize service users’ capacity to exercise personal autonomy and choice, as discussed in the report under Standard 14. It is recommended that service users are supported and protected by the home’s recruitment policy and practices, in that current guidance is followed for every prospective staff member, including a new disclosure that includes a POVA check. It is recommended that the registered person ensures that all staff receive training appropriate to the work they are to perform, with regard to dementia care. Park Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Lane Care Home DS0000061234.V308887.R01.S.doc Version 5.2 Page 32 - 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!