CARE HOMES FOR OLDER PEOPLE
Park Mount 52 Park Mount Drive Macclesfield Cheshire SK11 8NT Lead Inspector
Helena Dennett Unannounced Inspection 1st December 2005 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 Mount DS0000006626.V263102.R01.S.doc Version 5.0 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 Mount DS0000006626.V263102.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Park Mount Address 52 Park Mount Drive Macclesfield Cheshire SK11 8NT 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) 01625 616459 01625 869080 pallottine.sisters@virgin.net The Pallottine Missionary Sisters Mrs Lesley Sheridan Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Park Mount DS0000006626.V263102.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. This home is registered for a maximum of 30 service users in the category of OP (old age not falling within any other category) requiring personal care only The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance which may be issued through the Commission for Social Care Inspection 17th May 2005 2. 3. Date of last inspection Brief Description of the Service: Park Mount is a purpose built home set in two and a half acres of mature grounds. There is accommodation for thirty service users in single en-suite rooms on two floors. There is a lift on the first floor. Meals are taken in small groups of seven or eight, in the four dining rooms. There is a kettle and fridge in each dining room where residents and their visitors can make a drink and have a snack. The kitchen facilities provided conform to the standards laid down by the Environmental Health Department. A chapel is situated within the home where all denominations are made welcome. Park Mount DS0000006626.V263102.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4 hours. The inspector visited part of the building, spoke with two residents and members of staff. What the service does well: What has improved since the last inspection?
The manager and staff have worked very hard on the care plans to make sure that they reflect the care residents’ needs. Discussion took place regarding further development of these. Residents meetings have been introduced since the last inspection. One resident spoken with said that she enjoyed attending these meetings. She had the minutes of a previous meeting in her room. She said that suggestions made by residents are acted on and that she felt this was very positive. Staff meetings are now held regularly as well so that all staff know what is expected of them and can raise any issues at this time.
Park Mount DS0000006626.V263102.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Park Mount DS0000006626.V263102.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Park Mount DS0000006626.V263102.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Assessments are carried out before a resident moves into the home to ensure that staff at the home can meet their needs. EVIDENCE: Residents who spoke with the inspector said that staff had visited them prior to moving into the home. The residents also said they felt that staff were meeting their needs. Intermediate care is not provided therefore standard 6 does not apply. Park Mount DS0000006626.V263102.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 &10 Care plans are in place for each resident to make sure that staff at the home are aware of residents needs and are able to care for residents adequately. Residents health care needs are met, referrals are made to other professionals as needed. Staff know residents well and treat them with respect. EVIDENCE: The manager and staff have worked very hard to make sure that each resident has a detailed plan of care in place. An assessment is carried out on admission to the home, and those seen were very detailed and informative. Discussion took place with the manager to ensure that more information is documented under the action staff have to take so that the resident and the member of staff is clear on the action/help required. Residents said that staff treat them well. They said they knock on doors before entering and address them by their preferred name. Staff have worked hard to try and improve the management of medicines in the home. The medicines are now dispensed in blister packs in the main,
Park Mount DS0000006626.V263102.R01.S.doc Version 5.0 Page 10 although there are some instances where they need to give medicines from boxes. The members of staff responsible for giving out medicines said they felt this method of doing medicines was safer and easier to follow. On inspecting the Medicine Administration Sheets (MAR) there were two occasions where staff had signed to say they had given a particular medicine. However the medicine had not been prescribed for that day. On one occasion it was signed that the resident had been given Warfarin 3mg tablet as well as a 2mg tablet. The member of staff said that only 2mg had been given and 3mg was signed in error. On checking the stock balance there was no stock of 3mg tablets of Warfarin available for that resident on the day in question and therefore could not have been given. On a second occasion members of staff had signed that they had given an injection on three consecutive days. All staff said that this was signed in error as the district nurse visits to administer any injections. Discussion took place with the manager and she agreed that staff must take care when signing the sheets to make sure that they only sign for the tablets they have given so that there is no confusion. One resident did not have her eye drops as prescribed. Another resident did not have her Adcal tablets as prescribed by the doctor. See Requirement 1 and Recommendation 1. Park Mount DS0000006626.V263102.R01.S.doc Version 5.0 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. There are enough activities provided to meet the needs of residents who can also go out and about in the local community when they wish. EVIDENCE: Residents spoken with said they liked living at the home. They can choose what they want to do. They said their visitors can come at any reasonable time and they are made feel welcome. One resident said that a suggestion made regarding activities at a recent residents meeting was being acted upon. As a consequence a notice board will be put up in the residents lounge area informing them of forthcoming events. She felt this would be of benefit to all the residents in the home. During the course of the inspection several residents were seen going out to the local shops or community. They appeared happy and relaxed. Several people from the local community visit for day care and residents can join them in the lounge area for activities if they wish. Mass is held in the home’s chapel every day for residents who wish to go. The vicar from the local community also visits regularly. Park Mount DS0000006626.V263102.R01.S.doc Version 5.0 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 There is a complaints procedure that provides information so residents and relatives know how to make a complaint. EVIDENCE: Residents who spoke with the inspector said they would approach the senior carer or the manager if they had a complaint. They said that they had no complaints and that they were satisfied with the care provided. Park Mount DS0000006626.V263102.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 26 The home is clean and tidy and free from any unpleasant odours. EVIDENCE: The home was clean and tidy on the day of the inspection. There were no unpleasant odours noted. Residents said they were happy with the environment. They said the home was kept very clean and tidy. Park Mount DS0000006626.V263102.R01.S.doc Version 5.0 Page 14 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, &30 There is enough staff on duty at all times, to meet the needs of the residents. There is good training for care staff so that they can provide the best possible care for residents. All the necessary checks are carried out on staff before they start work at the home so residents are not placed at risk. EVIDENCE: Residents said there is enough staff on duty to meet their needs. Staff were seen to be professional in their work. They know the residents well and are aware of their needs. All members of staff are encouraged to develop their knowledge and skills through a training programme. A programme is in place to make sure that most of the staff have an NVQ Level 2 or equivalent qualification. The home is part of the Cheshire Consortium for training. This provides a resource for the manager to access training courses. A new computer has recently been purchased which will help staff with their training. Two personnel files were looked at. All the necessary checks had been carried out before the members of staff had started work at the home. Park Mount DS0000006626.V263102.R01.S.doc Version 5.0 Page 15 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): 31,32,35,38 The manager is very experienced so the home is run well for the benefit of the residents. Health and safety for residents and staff is well managed. EVIDENCE: The manager has many years of experience managing a care home. She is registered with the Commission for Social Care Inspection. Residents said they know the manager and find her approachable. Staff appeared relaxed in her presence and good relationships appear to exist. A system is in place to manage small amounts of residents’ money. Receipts are kept whenever possible. Transactions are signed. The residents spoken with felt that the introduction of the ‘residents committee’ was of benefit to them. They meet regularly and take any
Park Mount DS0000006626.V263102.R01.S.doc Version 5.0 Page 16 suggestions up to the manager of the home. They feel these have been listen to and action taken as a result. An example given to the inspector was the introduction of the notice board in the lounge area. Residents are given the minutes of these meetings to review. Staff meetings are held regularly and action taken if any issues are raised. Two members of staff are trainers for moving and handling and therefore can provide this training to all staff in-house to make sure that residents or staff are not put at risk. A risk assessment has been done on the environment to make sure that staff and residents are kept safe and free from unnecessary risks. The temperature of the water is recorded regularly. Audits on accidents and medications have not been carried out recently. It is recommended that the manager or a senior person carries out regular audits to identify trends and prevent reoccurrence of accidents and identify any bad practice that may arise with medication. See Recommendation 2. Park Mount DS0000006626.V263102.R01.S.doc Version 5.0 Page 17 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 3 X X N/A 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 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 x X X X X 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 3 X X 3 X X 3 Park Mount DS0000006626.V263102.R01.S.doc Version 5.0 Page 18 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 OP9 Regulation 13 Requirement Medicines must be administered correctly in accordance with the prescription and records of administration be kept up to date and accurate. (This is outstanding from the last three inspections Timescale 19/2/05 not complied with) Timescale for action 01/01/06 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 3 Refer to Standard OP8 OP9 OP38 Good Practice Recommendations Nutritional assessments should be completed for all residents on admission to the home. Monthly audits should be carried out on medicines. Regular audits should be carried out on accidents. Park Mount DS0000006626.V263102.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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