Inspection on 10/04/07 for Park View

This inspection was carried out on 10th April 2007.

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 View 13/12/05

Park View 03/05/05

Park View 12/10/04

Park View 17/06/04

Park View 16/12/03

Park View 20/05/03

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

CARE HOMES FOR OLDER PEOPLE Park View 7-10 Church Circle Farnborough Hampshire GU14 6QH Lead Inspector John Vaughan Unannounced Inspection 10th April 2007 10:10 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 View DS0000012061.V332623.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 View DS0000012061.V332623.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park View Address 7-10 Church Circle Farnborough Hampshire GU14 6QH 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) 01252 547 882 Mr Lawrence Alexander Mrs Diane Alexander Mrs Sharon Ann Botting Care Home 32 Category(ies) of Dementia - over 65 years of age (32), Mental registration, with number disorder, excluding learning disability or of places dementia (32), Mental Disorder, excluding learning disability or dementia - over 65 years of age (32) Park View DS0000012061.V332623.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the category MD referred to above are not to be admitted under the age of 55 years. 13th December 2005 Date of last inspection Brief Description of the Service: Park View provides care for up to thirty-two male and female residents over the age of 65 with mental health and dementia care needs. The home may also admit male and female residents from the age of 55 years with mental health care type needs. Mr and Mrs Alexander own the home and Mrs Sharon Botting is the registered manager employed by the home. Mr And Mrs Alexander own the Park Group of services that consist of Park View, Park Way and Park Avenue homes and an Outreach service. Park View is located in a quiet residential part of Farnborough and within a short distance from local shops and facilities. The home has an accessible mini bus that is regularly used for transport for outings and weekly shopping trips into Farnborough and Camberley. The home consists of two separate, sixteen bedded, three-storey Victorian style houses that are linked by a secure garden and patio area. Park View comprises of four single rooms and fourteen large double rooms. The homes communal space comprises of four open plan lounges, two dining rooms, and a quiet conservatory with adjoining activity room. The weekly charge for living in this home ranges between £375 and £550. Park View DS0000012061.V332623.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The visit to the home took place over one day and was unannounced. The inspector spoke to people who live in the home. The inspector also observed the interaction between staff members and people who use the service. The inspector met with staff and the manager and toured the home with the assistance of the manager. Records held in the home were also sampled. As part of the preparation for this visit the inspector examined information provided by the home to the commission and previous inspection reports on the service. What the service does well: What has improved since the last inspection? Decoration of the home continues, providing a homely and pleasant environment. A bathroom has been fully refurbished making it bright, modern and clean. Park View DS0000012061.V332623.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. Park View DS0000012061.V332623.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 Park View DS0000012061.V332623.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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The practices of the service means that individual needs are assessed and documented prior to admission to the home. EVIDENCE: The inspector examined a sample of three records for people who use the service during the visit to the home. Each person had a number of documents on file to demonstrate that an assessment of the individuals needs is completed. The inspector spoke to the manager who completed the assessment and care planning documentation. The files contained a pre-admission assessment and admission profile. Documentation and correspondence from specialists and consultants could also be seen on record. Park View DS0000012061.V332623.R01.S.doc Version 5.2 Page 9 The inspector was told that the manager visits the individual and if appropriate the family to discuss their needs and a plan is developed from this information. The home does not provide intermediate care. Park View DS0000012061.V332623.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are supported by care plans that document their needs and how these needs should be responded to and the planned improvements to how strategies are documented will enhance this support. Medication administration practices generally protect service users however recent administration errors does not demonstrate that safe practice is maintained. EVIDENCE: The inspector looked at three plans for people who use the service. These plans contained information on how to support the individual with their every day lives. Evidence was seen on file confirming that service users have support to access health care professionals and two service users went to the dentist supported by staff on the day the inspector visited. Park View DS0000012061.V332623.R01.S.doc Version 5.2 Page 11 One person told the inspector that they are aware of their plan and meet with a staff member regularly to discuss the support they need. The home has a key worker system and these staff members work with the individual reviewing their care plans and making sure their needs are being met. The plans are signed by the individual. A risk assessment checklist covers aspects of daily living and activities that present a risk to the individual are documented in the plan and a separate assessment is put in place to minimise the risk of harm or injury, these strategies include going up stairs, falls and using portable appliances. The inspector also noted that a persons needs had changed and the care plan and risk assessment had been updated to reflect this change. A service user told the inspector that the staff keep their cigarettes and money safe for them and they ask for these when they want them. This was discussed with the manager who discussed how they have identified people who are vulnerable to abuse and these approaches are in place to protect them. The manager agreed that these strategies must be documented and agreed with the individual or their representative within their plan. One plan seen by the inspector had very detailed support strategies and the manager said that this is the format that she intends to introduce for all people who use the service. Some aspects of supporting intervals with emotional and physical needs will be better addressed within this plan. The inspector examined the storage and administration of medication in the home with the manager of the service. The medication is held in secure cabinets, one in each of the houses. The method of dispensing has changed recently as the home has changed from one monitored dosage system in rigid containers to a blister pack system. Staff records and discussions with the manager and staff members confirmed that training in safe medication handling is provided and the manager will assess the competence of staff by observation of their practice. During the examination of the records the inspector and manager saw two instances were records had not been maintained correctly. Medication for one service user was not signed on two consecutive nights for one person and medication that should have been dispensed was still in the blister pack for another service user with no record of why this was still there. The manager stated that they would investigate these errors and take the necessary actions to ensure this would not occur again. Park View DS0000012061.V332623.R01.S.doc Version 5.2 Page 12 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): 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive a service that meets their social and leisure needs and this is enhanced by a service that welcomes and encourages family contact. Individuals make decisions about their lives and receive a balanced and varied diet reflecting their likes and dislikes. EVIDENCE: The inspector spoke to a group of people who use the service and they told him about the regular activities that they get involved in. Twice a week, a group go shopping to local markets and this trip is open to anyone who wishes to go. An activity worker visits three days a week and the group felt they had opportunities to get involved in a range of activities if they wished these sessions included art and crafts, board games and trips out to pubs and places to have a meal. Park View DS0000012061.V332623.R01.S.doc Version 5.2 Page 13 Individuals confirmed that the had support to practice their faith and each week a small group of people go to church either with the help of members of the church congregation or the manager of the home. The plans seen by the inspector had information on families and friends and important relationships. People who use the service confirmed that they maintain contact with their families and that there are no restrictions on visiting the home. Correspondence received from family members in e-mails to the home and completed satisfaction surveys was seen by the inspector. He noted positive comments about the approach of the home to caring for their relatives and how they are welcomed when they visit the home. Comments from the people who used the service were positive about the meals offered in the home. One person said that they had nice food that they really enjoyed, they make choices on a daily basis and if they don’t want a particular meal the can choose something different. Fresh fruit and vegetables were delivered from a local provider while the inspector was at the home and the cook stated that all meat and poultry is provided from a local butcher. Records are maintained of meals and staff were well informed about the likes and dislikes of the people who live in the home. Park View DS0000012061.V332623.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has systems in place to acknowledge and respond to the concerns of people who use the service and their representatives and procedures to protect people from abuse including training for staff are evident in the home. EVIDENCE: A complaints policy and procedure are in place and available to all people who use the service and visitors to the home. The inspector saw the procedure displayed in the home. This information was also given to the individuals or their representative when they moved into the home. People living in the home said that they knew how to raise a concern if the needed to and would talk to staff or the manager if they were unhappy and they were confident that the staff team and the manager would listen to them if they were concerned about anything. Staff have received training in the protection of vulnerable adults and the inspector found the staff he interviewed to be confident in their approach to supporting people and reporting any concerns about their care. Park View DS0000012061.V332623.R01.S.doc Version 5.2 Page 15 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, 23 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service live in a home that is clean, comfortable and safe and service users are able to have a bedroom that is arranged to meet their needs. EVIDENCE: The inspector toured the home with the assistance of the manager and had the opportunity to view a number of bedrooms. The manager confirmed that they are still working to a plan of reducing shared rooms in the home and as they become vacant the rooms are being converted. There are two separate buildings each with two interconnecting lounges, a dining room and a small room were people go to smoke. The inspector saw people making use of all of these areas. Park View DS0000012061.V332623.R01.S.doc Version 5.2 Page 16 People who use the service said that they felt comfortable in the home and their private rooms had everything that they needed. Some rooms are in need of redecorating and the manager stated that they had this in hand and the refurbishment of rooms is part of the annual plan for the service. One bathroom has been refurbished and the furniture in the small smoking rooms is also due to be replaced. The dining room furniture has also been replaced since the last visit During the tour of the home the inspector noted the kitchen and some doors to communal areas were wedged open. These were removed and later the inspector saw that some people in the home struggled to get around, as they could not open the door. The manager stated that they would arrange for suitable door retainers to be fitted after discussing this with the fire safety officer. Outside of the houses is a garden and patio area, which was in use by individuals throughout the day. Park View DS0000012061.V332623.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are supported by a staff team that is well trained and supervised and this is enhanced by recruitment practices that are robust and protect people. EVIDENCE: The inspector spoke to the manager about staff levels in the home. Each house has two staff on duty throughout the day and one staff member plus a sleep in staff at night. The manager stated that they keep this under review and will increase the numbers available if the needs of the people living in the home changed. When the inspector spoke to a group of service users they felt that there was always enough staff to support them. Staff members stated that they felt very well supported by their colleagues and the manager of the home they said that they are encouraged to develop their skills and training is fully supported by the home. Regular supervision takes place and staff meetings help to maintain communication. Park View DS0000012061.V332623.R01.S.doc Version 5.2 Page 18 One member of staff has taken on a role as learning representative and they explained the role to the inspector, which includes promoting learning and training courses within the staff team. A National Vocational Qualification (NVQ) programme is in operation in the home and discussions with the manager, staff and examination of records confirmed that staff are being supported to achieve this award. Records demonstrated that staff have attended mandatory training including Food Hygiene, First Aid, Health and Safety and Moving and Handling. An induction programme is in place to train and develop staff. Information provided by the manager indicated further training in dementia, palliative care, management of challenging behaviour, nutrition and fire safety. A programme of forthcoming training was available and this included training in food hygiene, risk assessment, moving and handling, protecting vulnerable adults, medication handling, fire safety and health and safety. Staff told the inspector that one area they had identified for improvement and development was activities and stimulation of people with dementia. The manager confirmed that they were looking at this area and provided information on training for staff that she is organising in supporting people with recreational and stimulating activities. Staff told the inspector that they are supervised regularly and have appraisals every six months. The manager stated that they encourage and support staff in the development of their skills and abilities and will look to provide training that meets their needs and the needs of the service. Three staff files were examined and found to have appropriate application forms, two written references, proof of identity and a completed Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) check. Park View DS0000012061.V332623.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported by a service, which is managed in an effective and open manner with established systems to ensure people’s views are acknowledged and used as part of the development of the service. EVIDENCE: The most recent inspections of the service have documented the significant experience of the manager. The manager has obtained the Registered Manager’s Award (RMA), they have completed NVQ levels 2 and 3 in care and are currently working towards completion of their level 4 award. Staff were Park View DS0000012061.V332623.R01.S.doc Version 5.2 Page 20 positive about the level of support they receive from the manager and that they found the management of the home to be open and approachable. The home supports people who use the service with the safe keeping of monies. The manager provided detailed records for individuals, which include receipts for any transactions. The service has an established system to involve individuals and their families in developing the home. An annual survey takes place and the responses were on file in the home. The managers of the organisation carry out an annual quality audit of the service based on the national minimum standards. Monthly management meetings, business planning and equal opportunity review meetings take place. Staff training is set out within a training and development plan for the year. A resident’s meeting takes place monthly and people using the service said that they are always encouraged to comment on the running of the home. Comments were very positive from people living in the home and their families including “ homely atmosphere”, “ very happy with care, treated with dignity” and “staff are always polite and helpful” The last survey is currently with the head office for analysis and the manager stated that this would be fed into the quality review. An action plan will be produced for any deficits following the audit. The home’s records confirmed regular testing and servicing of equipment, fire systems and staff receive regular training in fire safety. The inspector discussed the documentation of fire drills in a more detailed report to assist with the review of practice in the home and the manager agreed that this is needed. The manager is taking action to resolve the issue of propping open doors and will contact the fire safety officer. This will improve the accessibility of the home while maintaining the safety of all using the building in preventing the spread of fire. Park View DS0000012061.V332623.R01.S.doc Version 5.2 Page 21 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 3 X X X X 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 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 2 Park View DS0000012061.V332623.R01.S.doc Version 5.2 Page 22 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 OP9 Regulation 13.2 Requirement You must ensure that accurate records for the administration of medication to people are maintained at all times. Timescale for action 08/05/07 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 Park View DS0000012061.V332623.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Park View DS0000012061.V332623.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!