Inspection on 20/07/07 for Park Manor

This inspection was carried out on 20th July 2007.

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

The inspector 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 Manor 09/11/06

Park Manor 23/02/06

Park Manor 31/05/05

Park Manor 23/11/04

Park Manor 27/04/04

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 Manor 8 St Aldhelms Road Branksome Park Poole Dorset BH13 6BS Lead Inspector Catherine Churches Key Unannounced Inspection 10:00 20th and 23rd July 2007 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 Manor DS0000004055.V346683.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 Manor DS0000004055.V346683.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park Manor Address 8 St Aldhelms Road Branksome Park Poole Dorset BH13 6BS 01202 764071 01202 765505 No email 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) Park Manor Limited Mrs Janice Scanlon Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places Park Manor DS0000004055.V346683.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th November 2006 Brief Description of the Service: Park Manor is situated in a residential area of Branksome Park. The local area has a range of shops, a post office, library, public house and other leisure facilities. Public transport is accessible with bus routes and a train station nearby. Park Manor is a large house built in the late nineteenth century. Many of the original features are incorporated into the current building, which has been extended and adapted to accommodate older people. The home has substantial grounds, surrounded by mature trees and shrubs. The gardens are kept to a high standard. Accommodation at Park Manor consists of single and double rooms for service users, all with en-suite facilities; a passenger lift provides access to the first and second floor. Spacious communal areas are available to service users and include two sitting rooms, a large dining room and a smaller dining area. A large Victorian conservatory overlooks the well-maintained gardens. There is also a small interview room which is available to service users should they wish to receive visitors in private in an area other than their bedroom. The back of the house has been extended to provide 12 self contained apartments, each with its own front door and which include a sitting room, bedroom, bathroom with toilet and a small kitchen area. A lift operates on all 3 floors of the apartment block. The care, catering and laundry services of the main house also service the apartment block. At the time of inspection weekly fees ranged from £462 to £1000. Additional charges are made for hairdressing, chiropody, newspapers, toiletries, transport and telephone. See the following website for further guidance on fees and contracts: http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_people_ choos.aspx Park Manor DS0000004055.V346683.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over the two days of the 20th and 23rd July 2007 and took approximately eight hours. The purpose pf the inspection was to review the requirements and recommendations made in the last report and to assess all of the key standards. The Registered Manager, Mrs Scanlon, and her staff were on hand throughout both days to aid the inspection process. The premises were inspected and a number of records examined. Time was also spent time observing routines within the home and talking with residents, visitors and staff. What the service does well: Park Manor provides a homely, relaxed and comfortable environment with a welcoming and friendly atmosphere. The home is generally well maintained: some areas require attention but these matters are being addressed. The grounds are also attractive and well maintained. Medication is well managed at the home to promote health and well being. Residents say that staff are kind and caring and that their privacy and dignity is respected at all times. Residents are encouraged to maintain their links with family and friends and visitors to Park Manor are made welcome. People are positive about the food at Park Manor. Food is well presented and staff are available to assist residents if help is required. The Complaints and Adult Protection procedures ensure residents and their representatives that their well-being and comfort is important to the home and that any concerns raised will be properly investigated and resolved. Sufficient numbers of staff are on duty throughout the day and night to be able to meet the care needs of the residents. Park Manor DS0000004055.V346683.R01.S.doc Version 5.2 Page 6 The home is meeting the Department of Health target of having 50 of their care staff with National Vocational Qualifications in care at level 2 or equivalent. Financial procedures within the home also ensure that residents interests are protected. What has improved since the last inspection? What they could do better: Although improvements have been made in pre-admission assessments and care planning, further work is required. Assessments and care plans need to be more detailed about each need and how it is met. Care plans must be in place from the day of admission. Nutritional assessments should be undertaken and the information gathered in the monthly review should be used to inform and update the care plan. Scales should be provided which can weigh all residents. Evidence should be obtained that qualifications obtained by staff from other countries are equivalent to the standards set out by the Department of Health. Where the home holds cash for a resident, when a transaction takes place the resident as well as a staff member should sign the record to confirm or when the resident is unable, a second staff member should sign. Park Manor DS0000004055.V346683.R01.S.doc Version 5.2 Page 7 To ensure the best possible response to an emergency, the home should carry out unannounced fire drills and cleaning materials must be stored correctly. 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 Manor DS0000004055.V346683.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 Manor DS0000004055.V346683.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): 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Pre-admission assessments are undertaken to establish that the home can meet the needs of the prospective resident. Improvements have been made but there are still weaknesses which could mean that staff are not fully prepared to meet each persons needs from admission. EVIDENCE: The files of two residents who had been recently admitted to the home were reviewed. Assessments had improved since the last inspection as the documentation has been expanded to cover psychological and social needs as well as physical needs. It was noted that in many areas the assessor had merely recorded that Park Manor would provide the care but did not specify what the actual needs of the Park Manor DS0000004055.V346683.R01.S.doc Version 5.2 Page 10 person were. Prospective residents and/or their representatives had been involved in the assessment process. Park Manor DS0000004055.V346683.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 adequate. This judgement has been made using available evidence including a visit to this service. The care planning system has been improved. Each individual has a care plan and they are involved in its development and review. The care plan does not reflect the care that is being delivered. This means that the home cannot provide consistent evidence that appropriate care is delivered at all times. EVIDENCE: The care documentation for three residents was reviewed. Each file contained a variety of risk assessments, care plans, daily records and reviews. The structure of the care plan did not reflect the structure of the pre-admission assessment. At times it was not clear how information gathered prior to admission was transferred and used as part of the care planning process. Park Manor DS0000004055.V346683.R01.S.doc Version 5.2 Page 12 One person had been in the home for six weeks and no care plan had been created. Care plans lacked detail about individual care needs and how these were to be met. Reviews were being undertaken at the required intervals but changes in need were not always being reflected in an updated care plan. Nutritional screening was not being undertaken and the home was unable to weigh those residents who were not able to stand or bear weight. Care plans are now kept with daily records so that staff have ongoing access to them. Evidence was available that the resident and/or family member had been involved in the creation of the care plan. Residents confirmed that they have access to medical services. Records are kept of visits from GP’s, district nurses, chiropodist, optician and dentist. The home has a satisfactory medication policy and procedure. Medicines are stored securely and only those staff that have undertaken appropriate training in medicines administration are authorised to give medicines to the residents. Records were kept of the receipt, administration and disposal of medicines. Examination of records indicated that medicines are properly administered in accordance with the prescriber’s instructions. All residents spoken with said that their privacy is respected and that they were treated with dignity. Staff were seen to knock at bedroom doors and treated residents with courtesy and kindness. All residents seen were well presented. Park Manor DS0000004055.V346683.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. Park Manor provides a caring, homely and relaxed environment. People using the service are given the opportunity to take part in a variety of activities. Open visiting arrangements are in place enabling residents to retain contact with families and friends. Residents have the opportunity to choose their own lifestyle within the home and this means that their individual preferences and routines are respected. Dietary needs of the residents are well catered for with a balanced and varied selection of food available that meets resident’s tastes and needs. EVIDENCE: Prior to moving into the home, and following admission, residents are asked about their interests and hobbies. A calendar of events is produced on a monthly basis. Activities include scrabble on a large board, gentle exercises and church services. Some people also attend various clubs in the local community. The owners of the home have also provided money to enable the Park Manor DS0000004055.V346683.R01.S.doc Version 5.2 Page 14 home to purchase a fully accessible minibus which means that more trips out will be able to take place for a wider group of residents. The visitor’s book showed that there is a constant stream of visitors to the home and discussions with staff confirmed this as well as the fact that many residents are taken out by visitors. During the course of the inspection visitors were observed in the home. They were made welcome by staff and clearly had a good relationship with the staff. Visitors are welcome to stay for meals and there is also a guest room which visitors may make use of if they are visiting from a long distance. Discussion with residents and staff as well as examination of records and observation during the inspection evidenced that residents are assisted appropriately to exercise choice and control over their lives. Relatives and staff confirmed that, in their opinion, a suitable and varied diet is provided in the home. Foods records were examined and confirmed this to be the case. One mealtime was observed: food was nicely presented and assistance was being given to residents appropriately. Residents said they were enjoying their food. Park Manor DS0000004055.V346683.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. People who use this service are able to express their concerns, and have access to a robust, effective complaints procedure. They are protected from abuse and have their rights protected. EVIDENCE: The complaints procedure is included in the Service Users Guide/Terms and conditions of residence that is given to all residents/representatives and also available in the main entrance area of the home. No complaints have been made to CSCI or to the home since the last inspection. Policies and procedures for adult protection and whistle blowing were checked and found to be satisfactory. The majority of staff have received training in the prevention of abuse and the actions they should take if they suspect abuse. A very few staff were still not trained but a course had been booked for later in the summer to address this. Park Manor DS0000004055.V346683.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is nicely presented and well equipped. It is a very old building with ongoing upgrading which means that some areas are looking tired but plans are in place to address this. Residents live in a well-maintained environment, which was clean, hygienic and free from offensive odours. EVIDENCE: A tour of the premises confirmed that the home is nicely decorated and furnished. Dorset Fire and Rescue Service have visited the home and confirmed that it complies with their requirements. Since the last inspection a number of areas have been redecorated and a new hoist has been purchased for one of the assisted bathrooms. This demonstrates ongoing investment in the property. Park Manor DS0000004055.V346683.R01.S.doc Version 5.2 Page 17 Bedrooms are nicely furnished and residents have brought personal items such as furniture, pictures, photographs, ornaments and other items to help them personalise their rooms. The lounges and dining rooms are nicely decorated and furnished with a choice of seating available to residents. Staff had a good understanding of infection control procedures and the relevant protective clothing was available. There was a detailed infection control policy in the home that covered all of the required areas and staff confirmed that they had received training in this area. Training records were also available to support this. Park Manor DS0000004055.V346683.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. The deployment and number of available staff was sufficient to meet the needs of the residents. Staff have experience in caring for the elderly, a number have already achieved the minimum vocational qualification and others are undertaking training. This means that attention given to developing staff abilities and competencies. Recruitment procedures are satisfactory and this gives further protection to residents. Induction of new staff is undertaken within the timescales and to a good standard. This means that staff have the necessary skills to enable them to undertake all aspects of their role competently. EVIDENCE: Examination of the staff rota and observation throughout the inspection demonstrated there was a sufficient number and skill mix of staff to meet the Park Manor DS0000004055.V346683.R01.S.doc Version 5.2 Page 19 needs of residents. Staff and residents spoken with confirmed that they were satisfied with staffing levels. It was noted that Staff surnames were not recorded on the rota and that a number of staff were frequently working fourteen hour shifts. The staffing structure of the home is very flat with no senior posts, just a manager and deputy. This means that in the absence of both the manager and deputy there is no clear person in charge of the home. Six of the seventeen care staff have achieved NVQ level 2 and a further four are studying for NVQ level 3. There are also 3 staff that have nursing staff qualifications from other countries and the manager is obtaining evidence of the level of qualification that this is equivalent to. Staff records were examined for three new members of staff. These demonstrated that appropriate recruitment practices are in place: application forms were completed; interviews documented and appropriate evidence of identity and qualifications had been obtained. References, Criminal Records Bureau and POVA checks had also been completed as required. The new Skills for Care induction programme has been implemented in the home and evidence that new staff were undertaking this was available. Park Manor DS0000004055.V346683.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 adequate. This judgement has been made using available evidence including a visit to this service. The Manager has the required qualifications/experience and is competent to run the home. She works continuously to improve services. The home regularly reviews aspects of its performance through a good programme of self-review and consultations, which include seeking the views of residents and relatives and is being expanded to other stake holders. The health, safety and welfare of residents and staff is for the most part protected by the systems that the home has in place. There are some inadequacies. This means that the home cannot demonstrate that residents are safe and fully protected. Park Manor DS0000004055.V346683.R01.S.doc Version 5.2 Page 21 EVIDENCE: Mrs Scanlon has a number of years experience in a management capacity of a care home and has also undertaken the NVQ level 4 in management and the Registered Managers Award. All staff and residents spoken with spoke positively about her and were comfortable with approaching her if they needed to. The home has detailed policies and procedures for the promotion of quality assurance in the home. Mrs Scanlon confirmed that residents meetings and surveys are undertaken and that she and the owners of the home were continuing to implement a wide programme of quality audits of all aspects of the home. These audits are analysed and the results shared with the residents together with any action plan that may be required to improve services. Mrs Scanlon confirmed that residents are encouraged to retain control of their own finances for as long as possible. Where they state that they no longer wish to or they lack the capacity to do so then the home ensures that either family or other representatives such as solicitors take on this role. Cash is held for a few people. A sample number of records and balances were checked and found to be satisfactory. It was noted that only one person signs for any transaction. Fire records, staff training records and accident books were examined and found to be up to date. It was noted that the content of the training was not recorded and that drills were being undertaken as part of the training rather than without warning to test skills. Cleaning chemicals were left unattended in the first floor corridor for a long period of time. Park Manor DS0000004055.V346683.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 X X 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 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 2 Park Manor DS0000004055.V346683.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15(1) Requirement All residents must have a plan of care from the day of admission which sets out in detail the actions that must be taken by staff to ensure that all aspects of their health, personal and social care needs are met. Care plans must be reviewed regularly and any changes must be reflected in the care plan. If changes occur before the planned date of review then these must be added to the care plan. Nutritional assessments must be carried out and regularly reviewed. Scales, which can weigh all residents, must be provided. Timescale for action 31/08/07 2. OP8 12(1) 31/08/07 Park Manor DS0000004055.V346683.R01.S.doc Version 5.2 Page 24 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 2 Refer to Standard OP3 OP27 Good Practice Recommendations Pre-admission assessments should be more detailed to provide evidence that each persons needs are understood and can be met by the home. Staffing rotas should show the surnames of all staff. The practice of operating 14 hour shifts should be reviewed and it should be clear, at all times, who is in charge of the home. Evidence that qualifications obtained abroad are equivalent to UK requirements should be obtained. The content and duration of staff training in fire safety should be recorded. Fire drills should be held without prior warning of the staff to enable management to assess the adequacy of training. Cleaning materials should be stored securely and not left unattended. 3 4 OP28 OP38 Park Manor DS0000004055.V346683.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Manor DS0000004055.V346683.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!