Inspection on 01/02/07 for Park Lodge Nursing and Residential Care

This inspection was carried out on 1st February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Park Lodge Nursing and... 16/01/06

Park Lodge Nursing and... 01/09/05

Park Lodge Nursing and... 27/01/05

Park Lodge Nursing and... 14/05/04

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

CARE HOMES FOR OLDER PEOPLE Park Lodge Nursing and Residential Care 10 Park Avenue Roundhay Leeds Yorkshire LS8 2JH Lead Inspector Sean Cassidy Key Unannounced Inspection 1st February 2007 09:30 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 Lodge Nursing and Residential Care DS0000001365.V328278.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 Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park Lodge Nursing and Residential Care Address 10 Park Avenue Roundhay Leeds Yorkshire LS8 2JH 0113 2659353 0113 2650942 park.lodge@ashbourne-homes.co.uk 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) Ashbourne Homes Limited Louise Elizaberth Taylor Care Home 51 Category(ies) of Old age, not falling within any other category registration, with number (51), Terminally ill (6) of places Park Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of service users aged between 55 and 65 years of age should not exceed 3. 16th January 2006 Date of last inspection Brief Description of the Service: The home provides both nursing and residential care, and although registered for 51 places, some shared rooms are being used as singles, reducing the number of available places to 48. It is located in a residential area of the suburbs of Leeds and is near Roundhay Park, but still within walking distance of local facilities, which include shops, public transport and a post office. It is a large adapted building and accommodation is mainly in single rooms, many with en-suite facilities. There are gardens, with seating areas, to the front and side of the building. Communal areas are somewhat cramped given the potential number of people who may wish to use them, but planning permission is being sought to build a conservatory along the front of the building, which would provide an additional seating area. The fees charged by the home range from £400-£475 per week. Park Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The accumulated evidence in this report has included: • • • A review of the information held on the home’s file since the last inspection. Information submitted by the registered provider in the pre inspection questionnaire. Information received from service users, relatives, staff and other professionals. An Unannounced visit to the home was conducted by one inspector and lasted one day. The majority of this time was spent speaking to residents, management, staff and relatives. The visit included a tour of the premises. A number of documents were examined which included care files, training files, recruitment files and health and safety details What the service does well: The home offers prospective and existing residents good information relating to its service. The home ensures residents care needs are identified and provided for within the care plan and risk assessment documentation. Other professionals are involved with their care when needed. Privacy and dignity are promoted by the home and the staff. Residents feel the home offers them suitable opportunities for recreation and activity. They enjoy the choice of choosing whether to join in or not. Staff have a good awareness of adult protection issues. Attractive gardens are provided and accessed by relatives in the good weather. The domestic staff keep the home clean and tidy. The home ensures suitable numbers of trained staff are on duty to provide for the needs of the residents. The manager has developed good systems and processes for managing the home to a good standard. Park Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The Service User Guide must be reviewed to ensure all the required information with regards to fees is included. The residents must be assessed with regards to the possibility of selfmedicating. Those who are assessed as able to self medicate should be encouraged to do so. The home must actively involve the resident group with decisions regarding what food is planned in the menu. This menu must be accessible to all and in formats that are appropriate to their needs. Appropriate assistance must be provided to those residents in a manner that respects their dignity. The home must continue with their attempts to provide more communal space for the resident group. The home must ensure those residents that need the call bell close to hand do so. NVQ training to Level 2 standard must be provided to at least 50 of the carers working in the home. The environment of the home must be risk assessed appropriately to ensure health and safety. Park Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 7 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 Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 8 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 Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 9 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 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their representatives receive good information to assist them with making a choice about the home. The home assesses all residents before they move in. EVIDENCE: The home has developed a Statement of Purpose and Service User Guide, which are made available to all at the point of entry to the home. The Service User Guide does not contain the required information with regards to the fees and whose responsibility it is for paying them. Park Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 10 Residents and relatives spoken to said they were given sufficient information to make a choice about moving in. Two residents said they were given the opportunity to come and visit the home before moving in. Residents files showed that each person was appropriately assessed before they were admitted to the home. Park Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 11 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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home identifies care needs and sets out a plan of care to assist staff with meeting those needs. This is carried out in a manner that respects the privacy and dignity of the resident group. EVIDENCE: The care plans for four residents were inspected. Each file contained the assessed needs of the residents and for each identified care need a care plan was in place. The care plans are reviewed regularly and residents and relatives are involved with six monthly reviews of the care. Residents confirmed that this did happen. Residents spoken to said they were referred to other health care professionals when they needed it. The care plans showed evidence that this happened. Park Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 12 Several health care professionals returned questionnaires about the service. All said they were confident that the home contacts them at the appropriate time when a resident needed referral. The care files contained evidence to show that the residents are appropriately risk assessed in areas such as pressure area care, falls, continence and nutrition. These documents were reviewed regularly and changes were made when identified. Medication charts seen showed the standard of medication administration within the home is good. The charts showed no omissions in medication and when a medication was not given a reason was recorded. Evidence was not found to show the home assesses residents for selfadministration of their own medication. There is a medication policy, which contains a risk assessment document for this process. Three residents spoken to who entered the home said they managed their medications well up to the point of moving in. They said they were not asked if they wished to continue to self medicate and that the home took on of this role for them. Residents who were able to comment spoke highly of the staff group and the way in which they provided their personal care for them. Some comments made were, “They are fantastic. They can’t do enough for you.” “They are very attentive to my needs. They answer the buzzers efficiently.” “ The carers are very respectful of my privacy and dignity.” Staff were observed to be very pleasant and attentive over the course of the day and were observed to knock on residents doors before entering. Park Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 13 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 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are happy with the way in which the home attempts to meet their social needs. Not all are happy with the standard of food provided. EVIDENCE: Residents said they were happy with the provision of activity provided within the home. There is an activity person employed who records what activities each individual has been involved with over the course of the day. Staff were seen to be actively involved with those residents who were not as responsive to stimulation as some of the others in the group. They assisted two residents with getting involved with a painting activity. Residents said they are informed of what activities are on offer and that they were able to choose which ones they wanted to get involved in. Three residents spoken to said that the home encouraged them to leave the premises Park Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 14 whenever they were able to. This involved being accompanied by a member of staff on some occasions. Residents, relatives and friends said they were happy with the visiting arrangements provided by the home and were welcomed whenever they arrived. The lunchtime meal was observed and this appeared to be a social occasion. Residents were assisted where needed. Not all carers assisted residents with their meals in a manner that would have been expected to promote dignity. Two carers were seen standing over two residents and had no communication with those individuals during the mealtime. The home offers a varied menu, which is on display for residents to view. Three residents spoken to said they had no idea what was on the menu until they were asked on the day what they wanted to eat. They were not aware of the menu or where to look to see what choices they had on it. These residents said they had not been consulted about what they would like to have on the home’s menu and thought it would be a good idea. The menu runs on a four monthly rota. The rota did not always marry up with what was given to residents on the day. Residents gave a mixed view of the meals served within the home. Some felt that it was good and they were happy but others felt it was poor and in need of review. Park Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 15 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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are well protected by the complaint and adult protection procedures adopted by the home. EVIDENCE: Residents spoken to during the inspection were aware of the complaint process and how they would go about making a complaint. One complaint has been made since the last inspection and the manager investigated this appropriately. The complaints procedure is made available to all in different areas of the home. All carers spoken to possessed a good understanding of what constitutes abuse and how they would deal with an abuse situation if they came across one. Although not all staff have received adult protection training there is an ongoing programme that will ensure this happens. An incident involving two members of staff, which could possibly have upset residents, was identified. The records showed the manager had dealt with this incident appropriately. Park Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 16 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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their representatives were positive about the overall environment. However, there are areas that still require improvement. EVIDENCE: The garden areas were attractive with co-ordinating garden furniture. A new call system, which links to the doorbell, has been fitted. There were a number of rooms in which residents were unable to get out of their bed or chair. They did not have call bells close to them to call for assistance if they needed it. This has been highlighted at previous two inspections and must be addressed by the manager. Communal space remains limited. A small office has been converted into a small lounge and there are plans to build on a Park Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 17 conservatory at the front of the building, which, if planning permission is agreed, will provide an additional seating area. The home was clean and tidy and there were no offensive odours. Policies are in place for dealing with spillages, infection control and hand washing. Two members of the domestic staff were able to demonstrate a good understanding of infection control and COSHH procedures. Refurbishment work continues within the home. Although the overall opinion from residents and others was positive with regards to the environment, some recognised the need for continual improvement. Park Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 18 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, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive care from a staff team who receive a good standard of training. EVIDENCE: The home has developed a four weekly staffing rota, which allocates staff to all shifts throughout the day. The residents and relatives spoken to during the inspection and those contacted prior to the inspection, were positive about the numbers of staff on duty. They said, “I don’t have to wait long to be attended when I need a member of staff.” “ They always seem to have time to sit and chat with me.” “ There always seem to be sufficient staff on duty when you visit.” Staff numbers on duty during the site visit were sufficient for the needs of the carers. The staff spoken with said that sometimes they get overstretched due to sickness, but overall, they said they seemed to manage. The home manager provided details of the numbers of staff that had received training to NVQ Level 2 standard or above. The manager confirmed that there is a rolling programme of ensuring staff are enrolled onto this training Park Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 19 programme and it is hoped that the 50 of care staff with NVQ Level 2 training will soon be achieved. The recruitment procedures adopted by the home were looked at. The recruitment files of the two most recent members of the staff group to be employed showed that all the correct information was obtained prior to employment starting. The manager was encouraged to ensure that all references are clearly dated to show evidence that they were obtained before starting work. The staff spoken to were positive about the training that is offered by the home. Each person spoken to identified that they had mandatory training in Manual Handling and Fire Training. Staff are also provided training in areas such as pressure area care, nutrition and diabetes. Park Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 20 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 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a home that is being managed well. EVIDENCE: The manager is an experienced nurse who has worked in the home for a significant period of time. Residents and relatives are aware of who she is and said they felt confident in approaching her if needed. Staff said they felt well supported by the manager and also felt they could approach her if they needed to. The manager has not yet completed training in management to NVQ level 4. Park Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 21 The manager reviews documents regularly. Supervision is provided to staff as set out in the standard. Staff confirmed this takes place. Regular resident/relative and staff meetings take place. The organisation also reviews the quality of the care on a monthly basis and forwards this information to the Commission for Social Care Inspection. The manager also reviews accident records monthly and action is taken to reduce risks when needed. The financial records for three random residents were examined and were correct. Appropriate receipts were kept with the records. The health and safety measures were seen and were assessed as good. Hot water checks, electrical checks, gas checks and equipment checks were recorded and correct. The environmental risk assessments were out of date and in need of review. The manager agreed that this would be done as a matter of priority. Park Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 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 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 2 x 2 x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Park Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 23 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 OP1 Regulation 4,5 Requirement The registered person must ensure all the required information is included in the Service User Guide. This refers to the absence of information regarding fees. The home must ensure that all residents are assessed to self medicate and this is promoted and managed when appropriate. The registered person must ensure all residents needing assistance with their meals do so in a dignified manner. The registered person must ensure all residents are consulted, where possible, as to what meals they would like to see served on the menu. The registered person must ensure residents have access to the menu and it is provided in formats that will be easily read. Additional communal space must be provided. Timescale for action 30/04/07 2 OP9 13 31/03/07 3 OP15 12 30/04/07 4 OP20 28(2)(h) 01/08/07 Park Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 24 5 OP22 23 This is outstanding from inspections on 27.1.05 & 1.9.05 & 1.6.06 The call system must be accessible to all residents when in bed, unless the reason for not doing so is explained in the care plan. 28/02/07 6 OP28 18 7 OP29 19 8 OP38 19 This is outstanding from 1.9.05 & 28.2.06 The registered person must 31/05/07 ensure that at least 50 of the carers are trained to NVQ Level 2 Standard or above. The registered manager must 28/02/07 ensure there is a system in place, which shows all required information needed prior to a carer commencing work has been obtained. Up to date environmental risk 30/04/07 assessments must be carried out for the home. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Park Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Lodge Nursing and Residential Care DS0000001365.V328278.R01.S.doc Version 5.2 Page 26 - 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!