Inspection on 15/08/06 for Park View

This inspection was carried out on 15th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 22/08/07

Park View 22/02/06

Park View 20/09/05

Park View 06/01/05

Park View 01/07/04

Park View 22/03/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Park View Park View Priory Road Warwick Warwickshire CV34 4ND Lead Inspector Deirdre Nash Key Unannounced Inspection 15th August 2006 3.15pm 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 DS0000042008.V307896.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 DS0000042008.V307896.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park View Address Park View Priory Road Warwick Warwickshire CV34 4ND 01926 493883 01926 491134 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) Warwickshire County Council, Social Services Department Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Park View DS0000042008.V307896.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd February 2006 Brief Description of the Service: Park View is a Local Authority home for elderly people, with thirty-five beds. It provides 28 permanent care places, 7 short stay/respite care places and 12 day care places. It is situated amongst largely sheltered housing on the edge of Warwick town centre. There are local shops within easy walking distance, but quite a steep hill into the town, making walking or pushing a wheelchair strenuous. There is car parking to the front and rear of the home. The home is within walking distance of the train station and ‘bus routes. Accommodation is provided on three floors. The ground floor is used for people on short stays and those coming in for day care, and has a restaurant, a conservatory, a lounge/diner, a hairdressing salon and the short stay bedrooms as well as the laundry, kitchen and domestic and staff offices. On each of the first and second floors are a lounge, a dining room and fourteen bedrooms, all with en-suite facilities. Each floor also has two bathrooms and a communal WC, and a very small office. The home is staffed over twenty-four hours. It has a management team of a manager, two assistant managers and two care officers, all full time, plus a clerical officer who works twenty hours a week. In addition the full staffing complement includes twenty-five care assistants, six domestic staff, a laundress and two cooks. The home also has a small bank of staff to call on when needed. The home does not provide nursing care. Residents who require nursing attention receive this from the community nursing service, as they would in their own homes. Fees for 2007/7 are £90.65 to £369.11 exclusive of some extras. Park View DS0000042008.V307896.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We looked at all of the information that we have received about this home and kept on our records over the past twelve months. The provider organisation has had appropriate contact with us about the home during that time and kept us informed about how residents are. After the last inspection in February this year, we asked them to send us an action plan detailing how they were going to improve the things that we pointed out as being below standard and they did so. We sent the home a questionnaire in May to fill in and bring us up to date with facts and figures about the home. It was properly filled in and sent back to us in good time. We sent Comment cards directly by post to a sample of residents to find out their views about the home but none of these were completed and returned to us. We will improve the way that we go about consulting residents who need independent help to complete these cards next time. The Inspector called on the home without notice late in the afternoon on a Wednesday, spoke to eight residents, spoke to staff and to the Manager, looked around the home and looked at records. The care of a sample of three particular residents was ‘tracked’ in this way in order to see if the home is providing a service that meets the national minimum standards. What the service does well: What has improved since the last inspection? Park View DS0000042008.V307896.R01.S.doc Version 5.2 Page 6 Records of the administration of medication have improved and some areas of the home that were looking shabby have been redecorated. 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 View DS0000042008.V307896.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 DS0000042008.V307896.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 The outcome for this group is good. This judgement has been made using available evidence including a visit to this service. Information about the home is available and the needs of prospective residents are properly assessed. Residents do not move into a home that cannot meet their needs. EVIDENCE: The care file for a new admission showed that the home had made a good pre admission assessment of her need. Another resident spoken to confirmed that she had made a gradual move into the home. Terms and conditions for care and accommodation were seen in care files. Some were not signed by the service user or their relative. It is recommended that where service users are unable to sign contracts, relatives are invited to discuss these terms and conditions with the manager to make sure that they understand them. Staff files showed that key workers have some training to meet the specialist needs of their residents but no dementia awareness/ care training. Many Park View DS0000042008.V307896.R01.S.doc Version 5.2 Page 9 residents in home have some confusion. Requirements are made in a section below to improve staff training to better meet and to anticipate residents needs. Park View DS0000042008.V307896.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. The outcome for this group is good This judgement has been made using available evidence including a visit to this service. The home develops written plans of care for residents underpinned by written risk assessments. Residents are supported to safely continue their lives and are well looked after. EVIDENCE: Care file contained a detailed service user plan with clear directions for staff on how to carry it out. The plans showed that they are reviewed monthly. Two residents who’s situation has changed recently after an incident did not have a new care plan to reflect this although handover records showed that staff had received new instructions for their care. A requirement was made by letter to the provider to do this immediately and show how decisions to change the way they are looked after were arrived at. Care files showed records of contact with routine and specialist health care services; weight monitoring records, dietary information and risk assessments, medication records and health ‘key events’. Park View DS0000042008.V307896.R01.S.doc Version 5.2 Page 11 Two short stay and two long stay residents spoken to confirm that staff treat them with respect and are careful about their privacy and dignity. One resident said, ‘the bath that I had today, you wouldn’t believe it, it was wonderful- she gave me the best bath I’ve ever had, I can’t tell you how lovely it was.’ Park View DS0000042008.V307896.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 The outcome for this group is excellent. This judgement has been made using available evidence including a visit to this service. The home is offering residents social and leisure opportunities and residents can move freely around the house and gardens. Living in the home does not compromise residents’ lifestyles any more than is necessary. EVIDENCE: The ground floor of the home was pleasantly busy morning and afternoon. The presence of day care and respite service users provide a changing scene in which permanent residents can participate. There were notices of daily events on the boards on all three floors. One resident spoken to confirmed the manager’s report that a few residents who are capable were being taken to Western Super Mare on holiday the following week. Another resident confirmed that the ‘drives around the Warwickshire villages’ as advertised on posters do take place and said how much she enjoyed last weeks trip out. There was a B-B-Q lunch on the first day of inspection. Two residents talked about the seaside theme days that have taken place in the home over the summer, featuring different popular seaside resorts with props and special effects and entertainers. Park View DS0000042008.V307896.R01.S.doc Version 5.2 Page 13 Residents confirmed that they can get up and retire when they please and that the food is fresh and seasonal. They talked about the Strawberries that they had. Small dining rooms on the first and second floor each have a small kitchenette and dishwasher. Staff report that some residents like to help to clear tables and load the machine sometimes. This contributes to maintaining their mental wellbeing. Tea served in the afternoon was very weak and badly made and a number of people complained about it. It is recommended that as for food, the cook establishes a standard for beverages that staff should follow with exceptions for stated individual residents preference. Park View DS0000042008.V307896.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 The outcome for this group is poor. This judgement has been made using available evidence including a visit to this service. A written record of an allegation did not reach the attention of the manager. A vulnerable resident was left unprotected from abuse. EVIDENCE: The central complaints log was looked at and complaints received were properly responded to and records made of the investigation and outcome. A relative had contacted the Commission during the week before this scheduled inspection with a concern about his father’s care after an incident that happened in the home. Although this relative had expressed dissatisfaction verbally over the ‘phone to the home this had not been recorded as a complaint. The Manager reported that she was aware of his concerns. It is good practice to make a record of verbal complaints. This is a recommendation. The manager did act in the best interests of everyone concerned over this incident but the paperwork to show a professional route to those decisions was largely absent. An inability to show clearly why and how things are being done can leave relatives worried. The home must make itself accountable for how it handles difficult situations. Park View DS0000042008.V307896.R01.S.doc Version 5.2 Page 15 Risk assessments had not been kept up to date in writing and there was no written risk management strategy to support the decisions and the action taken by the manager to keep residents safe over this matter. Although this matter was referred through the Protection Of Vulnerable Adult (POVA) procedures, social workers did not respond fully to help the manager of the home to protect people. She was left to manage it unsupported for over two weeks. In effect, new care plans had been put in place for both residents involved but these were not committed to writing. The Inspector found a record in the daily notes of one of the residents made the day before the incident that could have prevented it. The manager was not aware of this record and no action had been taken by the care worker who wrote the incident to report it to the management line as the policy and procedures state. The had home failed to protect a resident when they had warning of the danger the previous day. These important records are not read and the home relies on a verbal handover report at shift changes. Too much information is handed over verbally for staff to commit to memory. The manager was required to report this finding through POVA procedure and she sent confirmation to us the next day stating that she and social services were acting on it. A requirement is made that the Provider organisation investigate this failure by the home when the POVA strategy has run. A requirement is made to refresh POVA procedure training for ALL staff at the home. Park View DS0000042008.V307896.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, 22, 23, 26 The outcome for this group is good. This judgement has been made using available evidence including a visit to this service. The home is purpose built for the needs of the residents and residents use it freely and confidently. Residents enjoy a comfortable home. EVIDENCE: The home was clean and hygienic, the kitchen and laundry are kept in good order and staff understand effective hygiene procedures. The communal space on each floor was well used morning and afternoon although the ground floor lounge was a bit cramped with day care, respite care and residents from up stairs coming down to join in the activities. The first and second floor dining rooms have been recently redecorated and the Manager reports that the shabby second floor corridors are in a redecoration plan. Some residents were using the garden on both days of the inspection. Park View DS0000042008.V307896.R01.S.doc Version 5.2 Page 17 Two residents said that moving in to the home was a very positive choice for them as their condition had left them isolated in sheltered housing before. Park View DS0000042008.V307896.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 The outcome for this group is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are in keeping with the level of residents needs and staff are properly recruited. Residents experience a professional approach to their care. EVIDENCE: Three staff were on duty on each floor and residents were getting the care and attention that they needed. Cook and laundry staffs were also on duty so that care staff could concentrate on looking after residents. The home does use agency staff when necessary. There are women and men care assistants. Residents spoken to confirmed individual records that night staff are also attentive and alert to their needs. Personnel files showed proper recruitment procedures and all information and proofs necessary to protect residents from people that are unsuitable to look after them were in place. Files contained certificates of training. There was no evidence of recent Adult Protection procedure training although induction checklists showed that new staff are given a leaflet on the policy. Staff spoken to said they would have no hesitation to report any concerns they had about the safety of a resident. However see findings above where a record was made of a serious allegation but not brought to the attention of any manager. Park View DS0000042008.V307896.R01.S.doc Version 5.2 Page 19 Staff files showed that mental health awareness training had been undertaken by staff key working the residents in the Inspection tracking sample but two of these residents have some confusion and cognitive impairment; one other has profound communication difficulties. There was no evidence of training in dementia awareness, dementia care or communication skills. Staff must be offered training in specific skills knowledge and understanding this will help them to care for their key residents more effectively. A requirement is made to improve this. The manager reports that only one third of care staff in the home hold the National Vocational Qualification (NVQ) at Level 2. A requirement is made to improve this, as it does not meet the government national target for achieving a qualified workforce in social care. Park View DS0000042008.V307896.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, 32 33, 35, 36, 38 The outcome for this group is good. This judgement has been made using available evidence including a visit to this service. The home is well run, procedures support good practice and quality is routinely assessed. Resident’s benefit from a service that is being run in their best interests EVIDENCE: An acting manager who is not registered with us but was deputy to the previous manager and knows the residents and staff currently runs the home. A requirement is made for the Provider organisation to put forward a person to register as manager of the home. Park View is a local authority home with clear external lines of management. Warwickshire Adult Services social workers did not respond effectively to a POVA referral made by the home recently. The manager was left to manage Park View DS0000042008.V307896.R01.S.doc Version 5.2 Page 21 safe arrangements in the absence of clear decisions from the social worker teams. This led to a complaint to us from a worried relative. Staff and residents confirm observations and findings from this inspection that the manager runs the home well. It is our assessment from the inspection overall that outcomes for residents are good and that the home has the will and capacity to learn from its recent shortfalls on Protection. Observation showed the ethos of the service is clearly to enable residents to maintain as much independence as possible and this was articulated by staff spoken to. There was evidence that the home does respond well to the limited cultural diversity that it experiences. A worker with some ability in Spanish has been identified to support a Spanish speaking resident. Residents commented that staff are patient with every one no matter how demanding or challenging. Staff were seen responding to residents with cognitive impairment and learning disability in an enabling way. One relative did comment that Park View is run more for the benefit of women than men. The Commission has been notified over the past months of significant events by the acting manager, as the regulations require. Quality questionnaires were seen completed in residents care files and the Manager reports that the provider organisation carries out a quality assurance exercise annually. A summary of the findings should be sent to the Commission. Monthly unannounced visits by the Provider to the home have not taken place since February 2006, they must resume and a copy of the reports must be available to the Commission so that we know that the organisation keeps informed about the home and residents well being. Records showed that one to one staff supervision sessions are patchy in their frequency; one staff member has had no one to one session this year with her line manager. This must improve so that the service to residents is consistent and that staff continue to be developed professionally. Records show that safety is taken seriously with fire safety equipment and lifting equipment regularly inspected and maintained and records made daily of fridge and freezer temperatures. Park View DS0000042008.V307896.R01.S.doc Version 5.2 Page 22 Personnel files show that staff receive up dated health and safety training. Observations of manual handling showed a safe and dignified approach by staff. Park View DS0000042008.V307896.R01.S.doc Version 5.2 Page 23 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 4 3 3 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 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 1 3 3 3 3 x x x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 2 x 3 Park View DS0000042008.V307896.R01.S.doc Version 5.2 Page 24 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 OP6 Regulation 15 Requirement Timescale for action 21/08/06 2 OP18 13 3 OP18 13 4 OP30 18 The registered person must ensure that the care plans and underpinning risk assessments for the two residents identified under in a letter sent to the Manager are re written to take account of present circumstances. Immediate The registered person must 17/08/06 ensure that the matter detailed in a separate letter is referred through the Protection of Vulnerable Adult multi agency agreed procedure. Immediate and complied with. The registered person must 14/09/06 ensure that the homes failure to act on an allegation made by a resident and written into her daily notes is investigated and a report on findings and plans for improvement in this area sent to the Commission. The registered person must 01/01/07 ensure that staff training to meet the needs of current residents as identified in their assessments is planned. The registered person must DS0000042008.V307896.R01.S.doc 5 Park View OP30 19 01/12/06 Version 5.2 Page 25 6 YA31 8 7 YA31 26 ensure that a plan for achieving the qualification of 50 of care assistants to NVQ Level 2 is devised and put in action. A copy must be sent to the Commission. The registered person must 01/10/06 ensure that a suitably qualified person is put forward to be registered with the Commission as manager to manage the home The registered person must visit 15/09/06 the home unannounced each month and submit a report to the Commission. 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 OP2 OP15 Good Practice Recommendations The manager should invite relatives to discuss the terms and conditions of care and accommodation at the home where residents cannot sign agreements themselves. The cook should establish a standard for beverages for staff to follow, with exceptions for stated individual residents preference. Verbal complaints and concerns to the home should be recorded. 3 OP18 Park View DS0000042008.V307896.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 View DS0000042008.V307896.R01.S.doc Version 5.2 Page 27 - 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!