Inspection on 05/12/06 for Park Street Home For The Elderly

This inspection was carried out on 5th December 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 Street Home For The Elderly 18/10/05

Park Street Home For The Elderly 25/05/05

Park Street Home For The Elderly 04/01/05

Park Street Home For The Elderly 24/05/04

Similar services:

Belma

Hunters Care Centre

Manor Lodge

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Park Street Home For The Elderly 10 Park Street Lansdown Bath Bath & N E Somerset BA1 2TE Lead Inspector Jon Clarke Unannounced Inspection 5th December 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 DS0000008159.V322608.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. DS0000008159.V322608.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park Street Home For The Elderly Address 10 Park Street Lansdown Bath Bath & N E Somerset BA1 2TE 01225 425011 NONE 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) Mrs Alice Togher Mrs Alice Togher Care Home 10 Category(ies) of Dementia (10), Dementia - over 65 years of age registration, with number (10), Mental disorder, excluding learning of places disability or dementia (10), Mental Disorder, excluding learning disability or dementia - over 65 years of age (10) DS0000008159.V322608.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. The total number of people who may be accommodated in the home at any one time shall not exceed 10. All service users accommodated must be ambulant and able to use the stairs independently. The home may, at any one time, accommodate up to 10 people with dementia aged 65 years and over. The home may, at any one time, accommodate up to 10 people with mental disorder (not dementia) aged between 55 and 64 years of age. The home may, at any one time, accommodate up to 10 people with mental disorder (not dementia) aged 65 years and over. The current service user whose needs do not fall in to either the MD or DE categories may continue to be accommodated in the home until such time as that person does not wish to remain in the home or the home is unable to meet that person’s needs. 18th October 2005 Date of last inspection Brief Description of the Service: Park Street is a converted three storey Georgian town located in the centre of Bath with easy access to local shops and amenities. The home provides accommodation for 10 residents with 4 single and 3 double rooms, 2 of the rooms have en-suite facilities. The one communal lounge is on the first floor with dining room on the ground floor. There is no lift available and therefore the home would not be suitable for individuals who could not manage stairs. The home is registered to provide care for older people with dementia, individuals aged between 55 and 65 with a mental disorder and individuals over 65 with a mental disorder. The philosophy of care is that Park Street aims to provide its service users with a secure, relaxed and homely environment in which their care, well-being and comfort are of prime importance and all residents are assured they will be treated with respect and dignity according to their individual needs and wishes (From the homes Statement of Purpose) Fee £405-£650 Dependant on individual needs. DS0000008159.V322608.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, which took place over one day. The manager and deputy were present throughout this inspection. A number of records were looked at including care plans, daily care records and those records relating to health & safety. The inspector also spent time observing staff to see how they interacted with residents and dealt with situations, which arose. Because of the mental health difficulties of the residents there was limited opportunity to talk with resident about the care they receive however a number of residents were spoken with as part of this inspection. What the service does well: What has improved since the last inspection? A requirement about obtaining evidence that employees are fit to perform the tasks expected was made at the previous inspection. The home has now put in place arrangements for this as part of their recruitment arrangements. DS0000008159.V322608.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. DS0000008159.V322608.R01.S.doc Version 5.2 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 DS0000008159.V322608.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good arrangements for assessing prospective residents so that they can be sure their needs can be met. EVIDENCE: Assessments seen provided an outline of care needs. Mental health assessments are obtained from the local authority which gave full information about the mental health and general health needs of the individual. A letter is sent to the individual or their representative stating that the home, subject to a trial period, can meet their needs. The contract arrangements of the home were looked at: there was no evidence of contracts being completed. The inspector was advised that they are sent to resident’s representatives and are part of the home’s Statement of Purpose. The contracts provide the necessary terms and conditions of living in the home. DS0000008159.V322608.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care Planning and arrangements for meeting health care are generally good providing staffs with the necessary information so that the health and social care needs of residents are met. There was limited information about the personal history of individuals, likes and dislikes. Arrangements for making sure resident’s medication make sure that resident’s health needs are protected. The practice of staff and policies of the home help to make sure that residents are treated with respect and their dignity is upheld. EVIDENCE: Care plans are completed as required giving good information about the individual’s care requirements and tasks needed. Reviews are held regularly or when needs of individuals change. In one instance when an individual had a stroke the home has needed to look at how to continue meeting her needs DS0000008159.V322608.R01.S.doc Version 5.2 Page 10 particularly when looking at how to meet her social needs and maintaining her contacts in the community. Residents have chiropody treatment as needed arranged through the home as well as dental and optician if this is necessary. There are good links with local GPs and mental health services. Staff were observed interacting with residents in a respectful way particularly where residents are confused or agitated and need re-assurance. In one instance a member of staff responded in a supportive way when intervening where a resident was becoming agitated and aggressive towards another resident. In talking with the manager and deputy they were very clear about the right of residents to be treated with respect and how to manage inappropriate behaviour whilst still maintaining the dignity of individuals. One resident said how she felt able “to come and go when I want”. DS0000008159.V322608.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for meeting the social and recreational needs of residents are good and there are opportunities for residents to maintain links with family, friends and the local community. The home’s practice and routines are flexible and enable residents to exercise choice and have control over their lives. EVIDENCE: Staff were observed interacting with residents and undertaking activities it is very much part of staff practice to sit in lounge with residents and wherever possible there is a member of staff present. The homes policy and practice is to encourage visitors to the home at any reasonable time and the manager confirmed this. Where able residents are encouraged to leave the home independently and one resident is accompanied by staff to visit the local shops and regularly goes into Bath. The majority of residents because of their mental health are unable to manage their finances and are supported by relatives or in some instances solicitors. Residents or their representative are invoiced for the care they receive. One DS0000008159.V322608.R01.S.doc Version 5.2 Page 12 resident is able to manage her affairs and is supported in doing so by the manager and deputy of the home. Wherever possible staff will enable residents to exercise choice and a member of staff spoke of how they will always ask residents what they want to do (this was about going to the lounge or staying in their bedroom) One resident finds it difficult to spend all their time in the lounge and staff are very clear that they can only cope for a limited time sitting with other residents. Two residents have their meals in the lounge area because again they are more comfortable in this area rather then the dining room. Menus and records of meals provided in the home showed that residents receive a varied diet. In talking with the cook it was clear she had a good understanding of the likes and dislikes of residents and was very keen to make sure residents enjoyed their meals recognising the importance of food in residents lives. Residents said the food was “always good” “I like the food here”. An inspection by environmental health in October 06 had found no areas of concern. DS0000008159.V322608.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has clear procedures in place and this enables individuals to make a complaint and voice their views about the service they receive and to know that they will be listened to and actions taken where necessary. EVIDENCE: No complaints have been made since the previous inspection. An admission questionnaire given to resident or their representative asks whether they are aware and have been given information about the homes complaints procedure. In looking at some returned questionnaires all stated they were aware of the homes procedure. The homes has policy about the protection of residents from abuse and staff have received BANES Adult Protection training. DS0000008159.V322608.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good, adequate or poor). This judgement has been made using available evidence including a visit to this service. The home provides a safe and hygienic environment for the residents and staff. EVIDENCE: At the time of this inspection the home was clean and free from offensive odours. A number of resident require assistance with maintaining continence and this is managed in an efficient way which makes sure that rooms and communal areas of the home are pleasant and there are no offensive odours. The home has sluicing facilities, which meet requirements to ensure hygiene, and infection control is maintained in the home. DS0000008159.V322608.R01.S.doc Version 5.2 Page 15 DS0000008159.V322608.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing arrangements in the home are satisfactory so that the needs of residents can be met in an efficient way with care being provided by skilled and competent staff. The recruitment and selection of staff is undertaken to make sure that as far as possible the health and welfare of resident is protected. EVIDENCE: Staffing rotas were looked at for period of 3 weeks and showed that there is good level of staffing in the home. At the time of this inspection there were 3 staff am and 3 pm this is the standard level of staffing. In talking with a member of staff they spoke positively of the level of staff and said that if there were additional pressures ie because of sickness additional staff will always be made available. Recruitment record showed that the necessary checks ie CRB, References had been obtained. The application form provided the necessary information including full employment history. Records also showed that new members of staff had completed the necessary induction and had the training required of the post namely Food Hygiene certificate. Staff have also completed training to provide them with necessary skills and knowledge about the residents they DS0000008159.V322608.R01.S.doc Version 5.2 Page 17 provide a service to ie Supporting People with Dementia, Managing Abusive and Aggressive behaviour. DS0000008159.V322608.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager of the home is an individual who is competent and able to run the home in a way that makes sure that resident receive the necessary care in a supportive and caring environment. The health & safety practices of the home help to ensure that residents live in an environment where they are protected as far possible from harm and their health and welfare is safeguarded. EVIDENCE: The owner and manager of the home Mrs Togher has an approach which centres on the needs of residents ‘ they are the important part of what we do’. DS0000008159.V322608.R01.S.doc Version 5.2 Page 19 She has a hands on approach which helps to not only monitor staffing practice but also provides her with direct knowledge of the needs of residents. In talking to her about residents it was evident that she has a real understanding based on considerable experience of the approach and care needs of individuals who have mental health difficulties. In particular she has built up knowledge of how to manage at times difficult behaviour in a communal setting such as a care home. Mrs Togher has NVQ 4 Registered Managers Award. Staff spoke of her in a positive way and how approachable and supportive she was. The home undertake quality questionnaires entitled “Living In The Home” which asks questions about catering and food, personal care and support, daily living and other areas of care. These are generally sent to resident’s representatives there were none available for examing on this inspection this will be looked at on the next inspection. However “Admission” questionnaires were available and respondents were very positive about staff responses to new residents. One relative said they felt their mother was “ very well treated, keeps telling us how good the staff are”. A professional who has visited the home over a number of years said they were “impressed by the personal care. The staff are always caring and treat resident with individuality”. Records showed good practice in health and safety with required checks of fire alarms (weekly), emergency lighting monthly. Fire drills take place as required the last being 10/10/06. Servicing of equipment: fire 03/07/06, gas boiler, PAT testing of electrical equipment 30/09/06. Recording of accidents is as required. An electrical safety certificate was issued in November 2006. The home also has all radiators covered to prevent injury to residents and this is a recommended practice by the Health & Safety Executive. There are also regulators on all hot water supplies and staff check bath temperatures. DS0000008159.V322608.R01.S.doc Version 5.2 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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X 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 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 DS0000008159.V322608.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000008159.V322608.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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. 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