Inspection on 02/08/06 for Park Riding

This inspection was carried out on 2nd August 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Park Riding 15/12/08

Park Riding 20/12/07

Park Riding 24/07/07

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

CARE HOMES FOR OLDER PEOPLE Park Riding 66 Greenfield Road Holmfirth Huddersfield HD7 1LA Lead Inspector Stephen French Unannounced Inspection 2nd August 2006 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 Riding DS0000066741.V298663.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 Riding DS0000066741.V298663.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park Riding Address 66 Greenfield Road Holmfirth Huddersfield HD7 1LA 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) 01484 684503 F/P01484684503 Mr Avtar Singh Samrai Mrs Angela Hinchliff Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Park Riding DS0000066741.V298663.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st November 2005 Brief Description of the Service: Park Riding care home offers accommodation and personal care for up to 15 older persons. It is a well established home situated in a residential area of Holmfirth. Rooms are situated on the ground and first floor, which is accessed by the use of a stair lift. There are two homely lounges a conservatory and a separate dining room. All bedrooms have a toilet and wash hand basin. The home serves traditional home cooked food. It has its own private grounds including a small putting green. The home is unable to accept service users who are immobile unless a ground floor room is available owing to the absence of a passenger lift. Park Riding DS0000066741.V298663.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out on the 2nd August 2006. The inspector arrived at the home at 9:30 am and left 3:00pm.Since the last inspection there has been a change in the ownership of the home. During this visit the inspector spoke to some of the service users, some of the staff and the home’s management as well as a relative. The inspector read care records, audited a sample of medication, reviewed staff recruitment and training records and carried out a tour of the building. Prior to the inspection 15 service user questionnaires were sent to the home to obtain service users’ views about living at the home. Eight completed questionnaires were returned. Comments included “ Its like one big happy family here” and “I am perfectly happy here” all eight commented that the food was very nice. One relative said “The staff are kind and helpful and that she is more than happy with the care her relative receives. Some service users in the home are very frail and would not be able to complete a questionnaire. There were fifteen service users resident in the home on the day of this visit. Relative surveys were also sent out and Three were returned. Other information used in the inspection process included notifications from the provider to the Commission for Social Care Inspection about deaths, illnesses, accidents and incidents at the home, copies of the monthly management visit reports produced by the provider and a pre inspection questionnaire completed by the manager. The provider informed the Commission for Social Care Inspection on the 2/08/06 that the fees were £344.71 per week. Additional charges include hairdressing, private chiropody, newspapers and some selected activities. Information about the home and the services provided are available from the home in the statement of purpose and service user’s guide, and service users are able to obtain a copy of these by contacting the home manager. Park Riding DS0000066741.V298663.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The home should keep a copy of the terms and conditions of admission which has been signed by the service user. Where a risk has been identified for a service user a risk assessment should be completed and kept under review. Care plans should be in place for problems identified through the risk assessment process. To protect the service users from harm the manager should record the running totals of the stock balances of night sedation, this will also enable her to audit medication more formally. Although service users spoken said that a choice menu was available this was not reflected on the menu seen. The Menu should state the choices of meals available. Park Riding DS0000066741.V298663.R01.S.doc Version 5.2 Page 7 The home should consider purchasing moving and handling equipement especially a hoist to enable staff to safely move service users when their mobility becomes compromised. 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 Riding DS0000066741.V298663.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 Riding DS0000066741.V298663.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,6 Each service user receives a terms and condition of admission document, however the home does not keep a copy of this once it has been signed by the service user. People’s needs are fully assessed prior to admission so the individual and the home can be sure the placement is appropriate. Quality in the outcome area is good This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Due to the home recently changing ownership the statement of purpose was examined to ensure the details of the new owners were recorded. The manager had commenced re writing the statement of purpose and the Inspector informed her of the information, which must be included. Each service user, who is funded by the local authority, has a local authority contract in place, which informs them of the fees and what their contribution Park Riding DS0000066741.V298663.R01.S.doc Version 5.2 Page 10 will be. The manager stated that the home also has a terms and conditions of admission document which the service user signs. Information within the contract includes what the fees are and there frequency and what is and is not included in the fees, unfortunately the home does not keep a copy of this. Before a service user moves into the home the manager receives a community care assessment, which has been completed by the service users social worker. This assessment determines the level of the care the service users requires. Once this assessment has been received by the home, the manager visits each prospective service user and completes a pre admission assessment. This assessment informs the home of the level of health and personal care the service users will require and from this the home determines if they are able to meet those needs. Three recently admitted service users care files were examined and contained pre admission assessments. One service user spoken to said that she had been visited by the manager prior to her moving into the home. The manager informed the inspector that the home does not offer intermediate care. Park Riding DS0000066741.V298663.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Although the health care needs of the service users are being met, the service users health would be better ensured if clear care planning systems were in place and the stock balances of night sedation medication was recorded in a separate book. Quality in the outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Each service user has an individual support plan which has been developed from information gathered from the community care assessment, members of the multidisciplinary team, service users and relatives. Three service users care plans were examined and care plans were in place for problems identified in the assessments. Risk assessments were in place for such things as nutrition, oral health, moving and handling and skin integrity. On the whole where assessments identified that the service user was at risk a detailed care plan was in place. One file examined which identified the service user as having mobility problems did not contain a moving and handling assessment. Park Riding DS0000066741.V298663.R01.S.doc Version 5.2 Page 12 It also identified the service user’ as being at risk of pressure damage but there was no care plan in place. There was evidence that the staff had accessed other members of the multidisciplinary team such as GP’s district nurses, opticians and chiropodists. Advice had been taken from the continence advisor from the local health authority and members of the mental health team. Care plans and assessments were reviewed monthly and there was evidence that, where they wished, service users and their family had been involved in the review. Senior care staff are responsible for the administration of medication. Staff have received training from the local pharmacist as well as completing a course which covers both the practical and theory aspect of the administration of medication. Service users are able to self medicate if they wish following completion of a risk assessment, staff would then support the service user in taking their medication. Medication seen on the day of the inspection was stored correctly. Three amounts of service users medication was audited against the records held within the home and the stock balances of tablets tallied with the medication administration records. The inspector advised the manager to keep a separate record of all night sedation given, this will enable her to audit stock balances on a regular basis. Park Riding DS0000066741.V298663.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Service users’ social, cultural, religious and recreational needs are being met and they are helped to maintain contact with their families and the local community. Service users are able to exercise choice and control over their lives. Although meals provided are wholesome and appealing this should be reflected in the menu. Quality in the outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Service users spoken to said that they were able to exercise choice in most things they did around the home. This included what time they went to bed and what time they got up. They are able to choose what they do during the day and can join in activities if they wish. Staff at the home are responsible for arranging social activities on a daily basis. These include arts and crafts, visits by outside entertainers and trips out to places of local interest. The home also has an astro turf putting green, which the service users have access to. There was evidence within the care files of what activities each service user has joined in with. Service users Park Riding DS0000066741.V298663.R01.S.doc Version 5.2 Page 14 spoken to said they were very happy with the social activities on offer within the home. The home has a four-week menu in place and all the service users spoken to said how nice the food was. On the day of the Inspection the lunch consisted of chicken in sauce with potato croquets and a selection of vegetables, followed by rice pudding. Although there was not an alternative choice recorded on the menu the manager and service users informed the inspector that an alternative would be made available. A tour of the kitchen was conducted and there appeared to be adequate stocks of fresh fruit and vegetables. The worktops in the kitchen are in need of replacing as they are worn and could cause cross contamination of food due to inadequate cleaning of the worn surfaces. Park Riding DS0000066741.V298663.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Staff awareness of safeguarding service users is good. Whilst complaints are few, service users know how to complain. Quality in the outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The home has a complaints policy, a copy of which is contained in the service users guide. The manager records complaints and the complainant is made aware of the outcome of any investigation. The last complaint received by the home was in July 2006 and evidence was seen that the manager had dealt with this appropriately. Service users spoken to said they were aware of the complaints policy and felt confident that the manager would address any issues they had. Care staff have received training in the protection of vulnerable adults organised by an outside agency and a further date is to be arranged for the remaining staff. Two staff questioned on this subject by the inspector gave good responses and were able to describe types of abuse and what they would do if they suspected a service user was being abused. Park Riding DS0000066741.V298663.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 Service users live in a safe, satisfactorily maintained home where their bedrooms are comfortable and decorated to a satisfactory standard. Service users independence would be further maximised if the home had a specialist bath and hoisting equipment to enable service users who may develop mobility problems bathe safely. The home is clean and fresh Quality in the outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: As part of the inspection a tour of the home was conducted. This included a number of service users bedrooms, communal areas, bathrooms and the laundry. Service users bedrooms were personalised with their own things such Park Riding DS0000066741.V298663.R01.S.doc Version 5.2 Page 17 as ornaments and pictures. Some minor redecoration and replacement of carpets is required in a number of bedrooms. There are two lounges a dining room and a conservatory were service users are able to sit. The furniture in the main lounge and conservatory is in need of renewing as it is looking tired and worn and some of the armchairs are ripped. There are a number of communal bathrooms and toilets within close proximity to service users bedrooms and communal areas. During a tour of these it was noted that a bathroom contained a number of personal items such as soap, talc, shampoo and dental cleaner. These were not named and it had to be assumed that they are being used communally. The bathroom on the first floor is in need of redecoration and a recommendation following the last inspection to have an assisted bath installed has not been actioned. It would be difficult for service users who have mobility problems to get into and out of the current bath, as there is no hoisting equipment within the home. There is a laundry, which is responsible for washing service users’ personal clothing. The standard of cleanliness throughout the home was very good and there were no unpleasant odours detected. Park Riding DS0000066741.V298663.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 On the day of the inspection there where adequate numbers of trained competent staff on duty to meet the needs of the service users. The recruitment practices of the home protect the service users from harm. Quality in the outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service EVIDENCE: The staff duty rota was examined for July and August and this confirmed the number of staff as being adequate to care for the basic needs of the service users living at the home. Since the new owner has taken over the home the manager’s hours are now supernumerary to the rota therefore she is able to spend more time supervising staff. Some service users comment cards received said that there where adequate numbers of staff available whilst others said that there did not appear to be enough staff on duty. A sample of recruitment records was audited and these were found to hold the correct information. Staff are recruited from a varied cultural background. There was evidence of induction and ongoing training. Staff members confirmed that training is available. Park Riding DS0000066741.V298663.R01.S.doc Version 5.2 Page 19 NVQ training is progressing and 45 of care staff have NVQ level 2 in care. Park Riding DS0000066741.V298663.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 The home is well managed and the manager is aware of her responsibilities. There are no formal quality assurance systems in place. Service users monies are held safely by the home. Staff are appropriately supervised. Quality in the outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The registered manager has nearly completed her registered managers award. She is aware of the aims and objectives of the home and has been Park Riding DS0000066741.V298663.R01.S.doc Version 5.2 Page 21 instrumental in maintaining the standards within the home. Service users and staff said she was very approachable. The manager said that although there are no quality assurance and monitoring systems in place she does audit care plans and medication although this is not completed formally and the actions following the audit are not recorded. The inspector advised that she introduces a quality-monitoring tool to enable the home to review and improve the aims and outcomes for service users. The manager said that service users are able to keep small amounts of personal monies within the home. This enables them to purchase small items such as sweets, newspapers and pay for hairdressing. Three amounts of service users monies held by the home were examined, and the balances tallied with the records held by the home. The manager conducts formal supervision of staff on a bi monthly basis. Records seen confirmed that this is taking place. Staff have received training in moving and handling, fire prevention and health and safety. Records examined confirmed this. The homes fire alarm system is checked weekly and contracts are in place with outside contractors for the servicing of the fire alarm system and fire fighting equipment. It was noted that the home does not have any moving and handling equipment such as hoists and slide sheets, although the current service user do not have major mobility problems at present, the home should invest in this equipment in order for them to be able to meet the changing needs of the service users living there. Accidents to service users and staff are recorded, and the inspector saw a copy of the accident book. Park Riding DS0000066741.V298663.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 3 3 x x N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 2 1 2 3 3 3 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 1 x 3 x x 3 Park Riding DS0000066741.V298663.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 Requirement Service users must have a care plan which details and informs staff what actions they are required to undertake to meet the needs of the service user. The home must have suitable arrangements to provide a safe system for moving and handling service users. A system must be in place for reviewing and improving the quality of care provided by the home. Timescale for action 31/10/06 2 OP22 13 (5) 31/10/06 3 OP33 24 (1) ab 30/11/06 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 Refer to Standard OP9 OP2 Good Practice Recommendations Running total balances of night sedation should be recorded in a separate book as well as on the medication administration records. A copy of the signed conditions of admission document should be kept on file. DS0000066741.V298663.R01.S.doc Version 5.2 Page 24 Park Riding 3 4 5 6 OP15 OP15 OP20 OP26 The menu should state the choices of meals available The kitchen worktops should be replaced The furnature in the lounges should be replaced as they are damaged and worn. Service users personal toiletries should be kept in their room Park Riding DS0000066741.V298663.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB National Enquiry Line: 0845 015 0120 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 Riding DS0000066741.V298663.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. 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