CARE HOMES FOR OLDER PEOPLE
Park Manor 8 St Aldhelms Road Branksome Park Poole Dorset BH13 6BS Lead Inspector
Debra Jones Unannounced Inspection 23rd February 2006 10:15 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.V284841.R01.S.doc Version 5.1 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.V284841.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Park Manor Address 8 St Aldhelms Road Branksome Park Poole Dorset BH13 6BS 01202 764071 01202 765505 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.V284841.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 31st May 2005 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. Park Manor DS0000004055.V284841.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over 2.5 hours on 23 February 2006 and was the second of the two anticipated inspections of the year. The 1 requirement and 2 recommendations made at a previous inspection were followed up to see if they had been addressed and they had been. The Inspector looked around the home and a number of records and related documentation were inspected. Jan Scanlon – the registered manager assisted the Inspector. The Inspector met and spoke with some residents in order to get a feel for what it is like to live at Park Manor. Residents were full of praise for the home and said they had no complaints. Prior to the inspection a number of comment cards were sent out by the home on behalf of the Commission. Of those returned 7 were from residents, 2 from Doctors surgeries, 1 from a care manager, 1 from a social care professional and 8 from relatives / visitors. Most comment cards returned were very positive about the staff and service provided at the home. Out of the 7 residents who returned comment cards all said that they felt well cared for and liked living at the home. What the service does well:
Park Manor provides a service for older people in a well decorated home that is furnished to a high standard. The home has a tranquil and relaxed atmosphere and residents are clearly at ease. The home is well organised and the care and contentment of residents is at the heart of the way the home is run. There is a robust system for medication administration at the home. Residents are able to do as they wish at the home and join in or not with the activities on offer. Visitors are always welcome at the home and residents are encouraged to maintain and develop relationships with people in the home, with their families and friends and the local community. Meals are varied and a choice is always available. Dining rooms are very pleasant and comfortable. Park Manor DS0000004055.V284841.R01.S.doc Version 5.1 Page 6 The complaints procedure reassures residents and their representatives that the well-being and comfort of residents is important to the home and that any concerns raised will be properly investigated and resolved. The home and grounds are very well maintained, comfortable and safe for the residents living there and anyone visiting. The home is kept clean and smells pleasant. Well trained staff in suitable numbers are employed to meet the needs of residents. The gaps in pre employment checks i.e. Protection of Vulnerable Adult and Criminal Records Bureau checks, must be addressed urgently. These things are important as they help ensure that only the right people are employed to look after residents. The home is run by people who have the qualifications and appropriate experience in caring for older people. Systems are in place and records kept, that demonstrate the homes commitment to keeping residents safe. What has improved since the last inspection?
Residents now have access to an up to date service user guide and statement of purpose that has current information on the facilities provided at Park Manor. Procedures for responding to suspicions of abuse have been revised so that they are in line with Department of Health guidance and this will ensure that any allegations of abuse will be managed effectively. Responses from resident surveys are analysed and acted upon. Residents are kept up to date about improvements at the home through newsletters further reassuring residents that the home is run in their best interests. Park Manor DS0000004055.V284841.R01.S.doc Version 5.1 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Park Manor DS0000004055.V284841.R01.S.doc Version 5.1 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.V284841.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 (Standard 3 was met at the last inspection. 6 is not applicable) Prospective residents are given sufficient information to make an informed choice about moving to Park Manor. EVIDENCE: The service user guide and statement of purpose have been updated. The new version is available in the main entrance hall. Current residents have been alerted to the update. Park Manor DS0000004055.V284841.R01.S.doc Version 5.1 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 (Standards 7, 8 and 10 were met at the last inspection) The medication at this home is well managed promoting the good health and well being of residents. EVIDENCE: Medication records sampled were up to date and properly completed. The number of tablets held in boxes accorded with the records for those sampled. Photographs of residents are held with the medication administration records along with sample signatures of staff who give out the medicines. Only staff who have been properly trained are allowed to carry out this task. Medicines and dressings were tidily stored in appropriate places. Records are kept of medicines that are stored and it is clear when these are brought into use. Records are also kept of medicines that are returned to the pharmacist. The maximum and minimum temperature of the fridge used to store medicines is regularly taken and monitored. Park Manor DS0000004055.V284841.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Residents’ lives are enriched by the social opportunities afforded by their visitors and the stimulating social activities available in the home. Visitors are made welcome at the home and can come whenever it suits the residents. Residents are helped and encouraged to exercise choice in their daily lives at the home. The meals in this home are good offering both choice and variety and are served in pleasant dining rooms. EVIDENCE: Some activities are arranged for groups such as team scrabble and movement and music. Both are very popular and residents talked of how much they enjoyed them. Outings are arranged in the home’s transport according to people’s expressed interests. Some people make their own entertainment. One resident holds a bridge club at the home. Another goes out to a local day centre. Park Manor DS0000004055.V284841.R01.S.doc Version 5.1 Page 12 Getting involved with the garden is also popular. Residents are encouraged to express opinions about how the garden should be landscaped / developed and work with the gardener growing plants in the conservatory. Care records note how people spend their days and if they have take part in any activities either arranged by the home or by themselves. At the request of residents a communion service is held monthly at the home. The 8 relatives who returned comment cards to the Commission said they always felt welcome at the home. Residents spoken to said that visitors were always made welcome. A guest room is available for visitors to stay. The visitors’ book confirmed the number and range of visitors to the home. The statement of purpose tells residents and their supporters that visitors are welcome at any time. People are encouraged to make choices about how they live their lives at the home. The home has an ‘automony’ policy which sets out the choices that people can expect to make at the home e.g. choosing when they like to get up and go to bed etc. Reference to choice is also made in the statement of purpose. Residents confirmed that they can do as they wish, choose to eat what they like and join in with activities as it suits them. Residents are encouraged to have a real input into the way that the home is run through resident meetings and monthly questionnaires. They are also kept informed about things that are going to, or have happened at the home through a regular newsletter. The importance of residents’ having ‘choice’ is covered in the induction programme for staff. There is a choice of hot meal at lunchtime and in the evening. The lunchtime meal on offer on the day of inspection was either roast chicken or quiche, served with a range of vegetables. The main dessert was melon cocktail. Alternatives were also available. The inspector spoke with some residents who were enjoying a drink before lunch in one of the lounges. They all praised the food. ‘it is very good, as it should be!’ Residents can choose where they have their meals. There are two pleasant dining rooms or residents can have their meals in their rooms should they prefer. The newest resident talked of how the home had consulted her about what she liked and she had been offered a choice as to where to have her meals. Fruit is always available for residents to help themselves. Special diets are catered for when required. Park Manor DS0000004055.V284841.R01.S.doc Version 5.1 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 A robust system is in place to deal with any complaints that might be made to the home. The home’s adult protection policy demonstrates the homes commitment to understanding abuse and of protecting residents but all staff are yet to be trained in this subject. EVIDENCE: The home has a complaints policy / procedure that is included in the information given and explained to residents. The policy is also on display in the home. A recent complaint was dealt with satisfactorily by the home. All seven residents who returned comment cards to the Commission prior to the inspection said that they were aware of the home’s complaints procedure. One resident said that if she had a complaint she would know who to ‘grumble’ to. The home has updated their adult protection policy so that it is now in line with Department of Health guidance so that any allegations of abuse would be managed effectively. The recruitment and disciplinary policies do not make reference to the POVA (Protection of Vulnerable Adults) list e.g. how staff are to be checked against this list prior to appointment, how staff could be referred to this list if they were dismissed due to abusive practice. Staff training in this subject is yet to be carried out at the home.
Park Manor DS0000004055.V284841.R01.S.doc Version 5.1 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 (standard 25 was met at the last inspection) Ongoing investment in the upkeep of the home maintains the comfortable and safe environment for the residents living there and anyone visiting. Bedrooms are well decorated, well furnished and personalised to suit the residents. The home is kept clean and smells fresh thereby making daily life for all in the home more pleasurable. EVIDENCE: The home has a warm and relaxed atmosphere. The home is well decorated throughout. Lounges and dining areas are comfortably furnished. Since the last inspection work has continued around the home to keep the environment up to its high standard. The grounds are well maintained, providing a lovely outlook for the residents. Residents can enjoy walks around the gardens and seating is provided.
Park Manor DS0000004055.V284841.R01.S.doc Version 5.1 Page 15 Residents are able to personalise their rooms with furniture and general belongings as they wish and in agreement with the home. There is a passenger lift in the home, enabling easy access between the floors. The home was clean and there were no unpleasant odours. The laundry was clean, tidy and well organised. Park Manor DS0000004055.V284841.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Sufficient, well trained care staff are employed and deployed to ensure that the care needs of residents can be met. Recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home but gaps in essential pre employment checks leave residents at risk of having unsuitable people working at the home. EVIDENCE: Clear staffing rosters are in place that show who is on duty, where, when and what jobs they do. During the days there are 5 carers on duty between 7am and 2pm; 3 carers between 2 and 5pm and 4 between 5 and 9pm. At night there are 2 waking and 2 sleeping care staff on duty. Care staff are supported by kitchen, cleaning and maintenance staff plus a gardener and management. The home is on target to achieve the Department of Health target of having 50 of staff with the NVQ level 2 in care qualification. The home also benefits by having some nurses trained in other countries working there. Not all staff have the appropriate checks carried out before they start work at the home i.e. CRB disclosures and or POVA 1st checks. Although applied for, confirmation of the outcome of checks against the Protection of Vulnerable Adults (POVA) list is not always received prior to the commencement of duties.
Park Manor DS0000004055.V284841.R01.S.doc Version 5.1 Page 17 Records are kept of training that staff undertake. These records showed that staff have access to a good range of basic training and receive their regular mandatory updates e.g. manual handling, food hygiene, fire, medication and infection control. Park Manor DS0000004055.V284841.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 and 38 (standard 35 was met at the last inspection) The home is well organised and the daily management and running of the home centres round the care and contentment of residents. Good management practice, systems in place, and records kept, confirm the health and safety of all in the home. EVIDENCE: Representatives regularly visit the home from the company that owns it, reports are made of these visits and copied to the Commission for Social Care Inspection as required by law. The manager – Jan Scanlon has successfully completed NVQ 4 in management and care. All records were available as requested at the inspection.
Park Manor DS0000004055.V284841.R01.S.doc Version 5.1 Page 19 An up to date insurance certificate was on display along with the home’s registration certificate. The home has expanded their quality assurance survey, whereby they find out more about what people think about the home, to carrying out regular analyses of responses. Residents are informed about how the home are addressing the outcomes of their surveys in the regular newsletters to residents and in their meetings. Any concerns raised by individuals are immediately followed up. Fire records were up to date and internal checks of fire safety equipment are being carried out at appropriate intervals. An external company carries out quarterly checks of the fire equipment. Fire training records for staff showed that all staff had had fire training at the required intervals. A file is kept of health and safety related matters including regular servicing of equipment. Accident records were looked at. These were well completed. Records were clear about how staff came across accidents or if they had witnessed them, what they did and any follow up that was needed. Analysis of such records would provide the home with important information as to the effectiveness of the emergency systems in operation and of any further measures that could be put in place to minimise risks to residents and it is suggested that this is done. Park Manor DS0000004055.V284841.R01.S.doc Version 5.1 Page 20 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 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 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Park Manor DS0000004055.V284841.R01.S.doc Version 5.1 Page 21 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 OP18 Regulation 13(6) Timescale for action The registered person shall make 01/04/06 arrangements, by training staff or by other measures, to prevent residents being harmed or suffering abuse or being place at risk of harm or abuse. It is required that staff records 01/04/06 be kept for all staff according to the Care Home Regulations Regulations 10 and schedule 2 (as amended through statutory instrument 2004 no 1770 which came into force on 26 July 2004). Requirement 2. OP29 19 and Sch 2 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 OP18 Good Practice Recommendations It is recommended that the recruitment and disciplinary policies and procedures be updated in respect of the POVA list. Park Manor DS0000004055.V284841.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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