Inspection on 18/03/08 for Park View

This inspection was carried out on 18th March 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Park View 16/03/09

Park View 09/03/07

Park View 05/06/06

Park View 10/11/05

Park View 17/05/05

Park View 09/12/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Pennine Camphill

Muston Road (70)

Grayling

The Cornerstone

John Street Nursing Home

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

CARE HOME ADULTS 18-65 Park View 100-104 County Road North Hull East Yorkshire HU5 4HL Lead Inspector Christina Bettison Key Unannounced Inspection 18th March 2008 09:30 Park View DS0000062146.V360820.R01.S.doc Version 5.2 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 DS0000062146.V360820.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 Adults 18-65. 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 DS0000062146.V360820.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park View Address 100-104 County Road North Hull East Yorkshire HU5 4HL 01482 448911 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) Kingston upon Hull CC Ms Judith Lawtey Care Home 15 Category(ies) of Learning disability (15) registration, with number of places Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Parkview is a purpose built establishment; it consists of three bungalows each of which have five single ground floor bedrooms, a lounge/dining room, one bathroom and two separate toilets. The three bungalows share a large garden but each has its own patio area. The home is registered to provide care and accommodation for up to 15 people who have a learning disability, and who may also have other physical needs, however since 12th May 2006 one of the bungalows has closed and some of the people have been re located leaving a total of eight people, four in each bungalow. The empty bungalow is now used for activity sessions, meetings, supervisions and a staff space. The home is close to local shops and next to a small park, and approximately 5 miles from the city centre of Hull. Public transport to various parts of the city is accessible and in addition people have access to a mini bus. Additional charges are made for the following: newspapers/magazines and sweets and hairdressing. Information on the service is made available via the statement of purpose, service user guide and inspection report. Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means that the people who use this service experience adequate quality outcomes. As part of this inspection surveys were posted out; five were returned from relatives, two were returned from professionals that visit the home, one returned from staff and two returned from people who live in the home. The site visit took place over one day in March 2008. The registered manager, senior care officer and all of the staff who were on duty on the day of the visit were spoken to and all of the people who live there and were in on the day of the visit were seen. Two visiting relatives were spoken to on the day of the visit. The interactions between staff and the people who live in the home were observed to find out how the home was run and if the people who lived there were satisfied with the care and facilities provided. The inspector looked around the home and looked at records. Information received by us over the last twelve months was considered in forming a judgement as part of the inspection process. Prior to the visit the inspector referred to notifications sent to the Commission for Social Care Inspection, the event history for the home over the past year and the completed Annual Quality Assurance Assessment all of which forms part of this inspection. The site visit was led by Regulation Inspector Mrs Tina Bettison and the visit lasted 7 hours. What the service does well: The people that live at Park View have complicated needs and are not able to tell staff what they need, therefore the care files must contain detailed information so that staff are guided as to how to meet peoples needs. All of the people that live in the home have an individual care file that has a lot of information which helps to make sure that they get the care and support they need, this includes a health action plan which helps to make sure that their health needs are met. The plans include helping people to keep their independence and learn new skills. The staff and managers know that they need to make sure that people are protected from harm and know what to do if someone is harmed. A good Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 6 recruitment policy is in place so that staff employed are safe to work with the people that live in the home. The people that live in the home and their relatives (who speak up on their behalf) are listened to and staff make sure they take action to sort problems out quickly. Relatives are made to feel very welcome in the home. The medicines are well looked after and all of the staff who give people medication have all received training and have been assessed as competent by the home manager. All of the people are now being helped to enjoy activities that they like, both in the house and out in the community, this means they have an interesting life and do not get bored. Training has been provided to all staff to make sure all staff are up to date with basic training in moving and assisting, basic first aid, basic food hygiene, infection control and fire awareness and special training has been provided to all staff e.g. how to deal with behaviour that may harm people or staff and to help them to meet peoples special needs. More than half of the staff have got a certificate (NVQ Level 2) which says they know how to work with the people in the home and how to meet their needs. The staff are very caring and treat people with respect and dignity. Staff have individual time with their managers to talk about their job, training and other things. What has improved since the last inspection? Observations indicated that staff members interact very well with the people that live in the home. There was a warm, friendly and relaxed atmosphere in the bungalows during the course of the visit. The people that live in the home appeared to be much more settled in their environment and with the staff. The plans are now looked at and changed regularly to make sure they are up to date and that people get the support and care they need, when it changes and when they need it. The people that live in the home are helped to attend activities and take part in the community on a regular basis. These activities relate to peoples individual diverse needs. The home has a permanent team of staff that are trained and are able to meet peoples needs. New staff joining the home have been helped to get to know the people and what their needs are and have been given basic instruction in the running of the home and the rules. Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 7 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 DS0000062146.V360820.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence including a visit to the service. People’s individual needs are identified prior to admission to ensure that the staff have the skills to meet their needs. The home provides sufficient information in suitable formats to help people thinking of moving into the home to decide if it’s right for them. EVIDENCE: There have been no new admissions to the home since the previous inspection and the homes statement of purpose and service user guide provides people with details of the services the home provides and enables them to make an informed decision about admission to the home. Care files examined each had a full needs assessment and care plan completed by the funding authority, in addition to this there were a range of assessments completed by health professionals and in house assessments which all help to ensure that peoples changing needs continue to be identified and met. There has been ongoing improvements in the quality of the care plans, health plans and risk assessments in the care files examined and these give staff clear guidance in how to meet peoples needs in a consistent way. Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence including a visit to the service. People’s needs are met and representatives have been consulted, and the quality of the plans and other records has been maintained, this ensures that peoples changing needs continue to be met. EVIDENCE: Three care files were examined as part of this site visit and all three included an individual plan detailing all elements of peoples needs and covering all items in NMS 2.2. In addition to this there were key information sheets detailing all relevant people involved, a focus page identifying basic need to know information for new staff, communication passport detailing peoples individual methods of communicating, management plans for epilepsy and dealing with behaviours Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 11 that may pose a risk, morning and evening routines, likes and dislikes, activities etc. Attention had been given to the development and maintenance of peoples independence, e.g. one person is encouraged to mix their Ready Brek for breakfast and pour their own cup of tea, another is encouraged to take away their pots to the kitchen after meals. There is good case file monitoring in place and most of the documents seen had been updated regularly and amended when needs change. There was evidence that peoples needs had been reviewed regularly using both the Social Services “Fair Access to Care” review system and “Person Centred Planning”. There had been significant improvement made in the recording of discussions and action to be taken in both kinds of reviews and that all parties views had been recorded and changes agreed are now being transferred to the plan so that peoples changing needs are met. Relatives told us: “The home is 100 better now and all the clients are given support for their own individual needs” “………...is given a lot of choice and I think her well being is paramount in the homes choice of things for her to do” Although there was a range of risk assessments on files;- moving and assisting, activities; bowling, cinema, swimming, fire, visitors, burns and scalds, use of the mini bus, some of the risk assessments seen were dated 2006 and did not appear to have been reviewed since then. In addition to this in one file the person had a risk assessment for the use of bed side rails, but this was very basic and did not meet the guidance recently issues by the MHRA. This needs to improve to ensure that risk is a managed effectively and people are kept safe from harm. A member of staff spoken to had only been at the home for 3 weeks, they commented that their induction had included reading the care files and that the plans and communication passports had helped to give them a quick overview of peoples needs. Where decisions needed to be taken for staff to act in the best interests of people, best of interest meetings had been held which involved relevant professionals, relatives, staff and the person themselves. A record of these meetings was held on file. Some staff have received training in the mental capacity act. Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,15,16 and 17 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence including a visit to the service. A range of activities provided within the home and community mean that people have the opportunity to participate in activities that meet their individual needs, wants and aspirations. EVIDENCE: Three care files were examined during the site visit and all files contained activity plans. One included;- bowling, swimming, aromatherapy and attending Hull FC rugby games, there were records to evidence that these had taken place and ticket stubs from the matches. Another file included; - aromatherapy, walks in the community, shopping and bowling. Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 13 In addition to the care staff and managers in the home two programme workers have been appointed. This is specifically to ensure that an activities timetable is developed and that activities both in house and in the community are promoted and encouraged. The additional staff resource has been invaluable in ensuring that people are able to live varied and interesting lifestyle that meets their individual needs, wants and aspirations. Relative told us: “………..now goes out at least twice a week, for a walk or pub lunch which she enjoys also ………goes on holiday once a year to a place we think she would enjoy, she doesn’t like noise or lots of people so she doesn’t go the shows or football matches that some of the others enjoy and attend.” “It is much better now, they go out a lot more, bowling, town, theatre and the gateway club” “There are more drivers now so they are getting out a lot more, cinema, bowling, gateway club exercise sessions at a leisure centre and church every other Sunday morning” “ the care staff at Park View do a really good job and take care of the residents in most of their needs. In social activities both in the home and their outside activities”. Observations indicated that staff members interact very well with the people that live in the home. There was a warm, friendly and relaxed atmosphere in the bungalows during the course of the visit. The people that live in the home appeared to be much more settled in their environment and with the staff. Family links continue to be good in the home; relatives commented on their involvement and in their relative’s life and stated that staff keep them informed and that communication is good now. Holidays are in the process of being planned and staff are taking into account experiences of last years holidays and observations to ensure that holidays planned are what the people want and will enjoy. Menus were planned but were subject to change if people preferred alternatives. Menus reflected that staff promoted a healthy eating menu and tried to balance this with people’s likes/dislikes and special treats on occasions. The staff members generally prepare the meals with people helping if they were able to or wanted to. The recent assessment of the kitchens by Hull City council under the “food safety act” graded them as an “A” which is excellent. Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence including a visit to the service. People health needs are assessed, identified and met by a range of professionals and staff in the home facilitate this, however plans need to be updated regularly to ensure changing health needs continue to be met and some needs are not being met due to Hull City Councils slow response to dealing with the refurbishment of bathrooms. EVIDENCE: The home have worked in partnership with the community nurse in facilitating the development of health action plans. All eight people have now had a full health screening completed and the development of an action plan. Three care files were examined as part of the site visit and all three contained a health action plan prepared by the community nurse that detailed some health needs. The provision of community nurse support continues to be Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 15 inconsistent meaning that further work on the action plans; liaison with other health professionals and updating of the records has not been achieved. These plans had been prepared over 2 years ago and although the home are ensuring that peoples health needs are met it would be beneficial for the plans to be updated more regularly so that areas of health need do not get overlooked and the home are able to be pro active in meeting needs rather than re active. There was evidence in all three files of appointments with e.g.; - GP, consultants, specialist epilepsy nurse, dentist, chiropody, physiotherapist, occupational therapist and dietician. Relatives told us: “At the moment we are having health issues with our relative and the staff couldn’t have been more helpful and caring” “I had concerns about my sisters diabetes levels also high cholesterol which both run in the family. I wanted her to have well woman check up, these things were checked on and now she is fighting fit” Health professionals told us: “ The care staff and manager contact the service if they have any concerns about individuals health needs. They also contact the GP practice with concerns. Staff appear to be very good at communicating with health care practitioners” However it was identified at the previous inspection that: “Bathrooms were still institutional, stark and uninviting. The specialised baths were quite old. One of the service users had been identified as being unable to have a bath due to their specific needs and the unsuitability of the bathing equipment (moving and handling risk assessments). The relatives of this service user informed the inspector that their daughter had not been able to take an immersion bath for over 2 years and this was an aspect of the home that they are still unhappy about. This is clearly unacceptable and the bathrooms at the home must be refurbished and specialised bathing facilities provided with some urgency” This situation has still not been resolved and the relatives were spoken to at this visit and confirmed that although there had been a lot of improvement in the home this was one aspect that they are still not satisfied with. The OT had written to the principal manager for learning disabilities at Hull City Council on 8/8/07 stating; - “ I am sure that you are aware that …………is not Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 16 able to use the bath at her home, nor has she been able to for approximately two years………………..one of her rights within her own home is not occurring and has not occurred for along time and this needs to be urgently resolved” At the time of the visit this was still unresolved and although the manager was aware that the home is due for refurbishment she had not been given any time scales from the resources department at Hull City Council. This is an unacceptable situation and the City council must take action to resolve this long overdue problem with some urgency Medication systems were examined and found to be in good order. Hull City Council have policies and procedures to cover all aspects of medicines management and to ensure that staff had the necessary guidance. All of the staff who give people medication have now all received training and have been assessed as competent by the home manager. Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence including a visit to the service. The home has a satisfactory complaints system, whistle blowing policy and procedures to ensure protection of people from the risk of harm which are all now being used effectively to ensure issues raised as concerns are looked into and resolved. EVIDENCE: The home has continued to improve and there have been no complaints made to the home or CSCI since the previous inspection. Relatives spoken to during the course of the site visit told us: “ we are highly satisfied” “if we have any problems we can talk to the senior staff anytime and talk about things and they listen to what we have to say and they try to help if it is possible” In all of the surveys returned relatives said they knew how to make a complaint on behalf of their relative. The home had received a number of compliments that were logged in the concerns, complaints and compliments file. These included; Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 18 • • • • • • A relative rang to say thank you for supporting ……..to purchase and send flowers to mum” An advocate said thank you for making him feel welcome during his visits Thank you to staff from another service provider for their hospitality during the floods Thank you from relatives for all the lovely care you gave over the last weekend, it was much appreciated Thank you taking our relative away to Blackpool for the weekend and for the care given to all of the residents at park view Thank you for taking our relative Christmas shopping and for giving all the residents a lovely Christmas, it is nice to know they are being looked after by dedicated staff. From the care files examined it was evident that people that self harm or display behaviours that are difficult to manage now have behaviour management guidelines. Any restrictions or limitations are documented in the form of a behaviour management plan. The home has policies and procedures to cover adult protection and prevention of abuse, whistle blowing, aggression, physical intervention and restraint and management of people’s money and financial affairs. There have been some occasions in the past year where the people who live in the home have hit out at each other or there had been some incidents of unexplained bruising. These have all been referred to the safeguarding adults co ordinator and dealt with accordingly. There are no concerns about the homes ability to safeguard the people that live there. From discussion with staff and staff training records it was evident that most of the staff including the manager and senor staff have received training or briefing on the Protection Of Vulnerable Adults Policies and Procedures and their responsibilities within this and some staff have completed mental capacity act training. Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,27,29,30 People who use the service experience poor quality outcomes in this area. We have made this judgment using a range of evidence including a visit to the service. The environment does not provide people with comfortable and homely surroundings in which to live, appropriate equipment is not being provided meaning that the home cannot meet all of peoples individually assessed needs. EVIDENCE: An inspection was undertaken on 17/5/05, which highlighted the need for improvements to be made to the environment, subsequent inspections repeated these requirements, despite this there have been no improvements made to the environment in almost 3 years. Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 20 Although the resources section of Hull City council have informed the manager that the home is on their plan for refurbishment they have not given any indication of the work to be undertaken and what the timescales are, the home must have a maintenance and renewal plan with timescales for the work to be completed. The home is very run down and this has got worse over time, there are numerous holes in the plasterwork, curtains hanging off the tracks, damaged doors, furniture is mismatched, old and broken and carpets are badly stained. It was noted at the previous inspection: “Bathrooms are still institutional, stark and uninviting. The baths are very old. One of the people had been identified as being unable to have a bath due to their specific needs and the unsuitability of the bathing equipment (moving and handling risk assessments). The relatives of this person informed the inspector that their daughter had not been able to take an immersion bath for over 2 years and this was an aspect of the home that they are still unhappy about. This is clearly unacceptable and the bathrooms at the home must be refurbished and specialised bathing facilities provided with some urgency” This situation has still not been resolved and the relatives were spoken to at this visit and confirmed that although there had been a lot of improvement in the home this was one aspect that they are still not satisfied with. At the time of the visit this was still unresolved and although the manager was aware that the home is due for refurbishment she had not been given any time scales. Since the closure of one of the bungalows there is now a private area for visitors and /or meetings consultations etc. Care managers told us: “The only problem I have encountered is who owns the building. This creates issues with who is responsible for repairs, and equipment, no one seems to be responsible” Relatives told us: “The only way that the home can improve at the moment is to have the home completely renovated” “The home needs redecorating/refurbishing and the bathroom equipment is still not in place” “The environment could do to be improved” Nine staff were spoken to on the day of the visit and without exception all stated that it was time the environment was improved. Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence including a visit to the service. The home now provides staff that are skilled and trained and are provided in sufficient numbers to meet all the needs of the people that live in the home. EVIDENCE: The manager produced a staffing list that showed that the home is now fully staffed. There are no vacancies across the site and all staff are permanently employed by Hull City Council. In the past year 13 care staff were redeployed from two other Hull City council services and have all been inducted and settled in well. In addition to this the senior care posts are filled and two programme workers have been appointed to assist with activities. This is a huge improvements and nine staff spoken to on the day visit told us;“Its a lot better, more positive, we are fully staffed with a reliable team and this means we can give more time to service users” Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 22 “Now were fully staffed its much better, working as a team” “More settled stable staff team, things are much better” “Its lovely now, we are able to give 1; 1 time and service users are lot calmer” “Things are lot better, staff morale is better, the vacancies are filled and it’s a regular staff team. Service users are more settled” The manager has completed a comprehensive training plan and keeps an up to date audit/matrix of training for staff. The Hull City Council training facility was badly damaged by the Floods that occurred in Hull in June 2007, this has meant that some training has been delayed, however the training schedule is back on track now. Staff are up to date with their mandatory training and most have completed values and attitudes and equality and diversity training. Staff have completed training in how to manage people that present behaviour that may pose a danger to themselves or others. The home has now achieved 50 of staff qualified with NVQ level 2 or above. Service specific training provided has included epilepsy, communication, eating and drinking, makaton and bowel massage. The speech and language therapist will be providing some training in intensive interaction. The quantity of supervision is as regular as it should be and the quality of the supervision records examined had improved significantly. Relatives told us: “we now have permanent staff team and the service users are lot happier with familiar staff, cant fault the managers and seniors, any concerns are dealt with” “Staff are brilliant, we are fully staffed and programme workers providing activities. Our daughter is a lot brighter now and her communication and interaction has improved” “Seeing the improvements in my daughters well being and behaviour over the last year. I think the staff are doing a great job” “Staff are very good” “Staff are excellent” “My wife and I would like to express our thanks to all staff who do a good job in caring for our daughter” Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence including a visit to the service. Significant improvements have been made in the development of detailed plans, health plans, provision of activities, staffing numbers and competence and the provision of training. The stability of the manager, senior care officers and a permanent, reliable staff team means the peoples needs are met in a well managed service, however this is being compromised by Hull City Councils slow response to dealing with environmental issues and the refurbishment of the home. Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 24 EVIDENCE: The manager is registered with the Commission for Social Care Inspection. The manager has undertaken a wide range of training related to the post of manager and has completed NVQ 4 in Management and the Registered Manager’s Award covering the appropriate care components. She has over 20 years previous experience in a managerial and caring role. Significant improvements have been made in the development of detailed plans, health plans, staffing numbers and competence and the provision of training. (See the main body of this report) The manager produced a staffing list which showed that the home is now fully staffed. There are no vacancies across the site and all staff are permanently employed by Hull City Council. In addition to this the senior care posts are filled and two programme workers have been appointed to assist with activities. Since a key inspection undertaken on 17/5/05 there has been no improvements to the fabric of the building, redecoration and provision of appropriate bathing facilities in the home. As part of the inspection all of the maintenance certificates were seen and were up to date. Staff were up to date with their mandatory training. The LA has a well developed regulation 26 visiting and reporting system in place that monitors the improvements being made and makes recommendations and the registered manager routinely uses the CSCI regulation 37 reporting system to keep the inspector aware of any events that have happened in the home. The QA process was not examined at this inspection however the home still need time to fully implement this within the home and ensure that they engage fully with the staff team, stakeholders, people who use the service and relatives and listen to their concerns and take action to make improvements within the home. Relatives told us: “I do think there has been great improvement in many areas, and I am personally quite happy with so much that has been achieved. Standards of care have improved immensely there may be more to be done as yet but I find the quality of care my son receives gives peace of mind knowing everything is being done to improve the quality of life of a loved one” Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 1 25 x 26 x 27 1 28 x 29 1 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 2 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 x 3 x 1 x x 2 x Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 26 yes Are there any outstanding requirements from the last inspection? 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 YA9 Regulation 13 (b) Requirement The registered person must ensure that risk assessments are updated regularly so that people are kept safe from the risk of harm. (Timescale of 30/06/07 not met) 2 YA9 13 (b) The registered person must assess the persons need for bed rails in line with the MHRA guidance and ensure that there is a correct match between the person, the bed, the mattress and the bed rail and keep a written record so that people are kept safe from the risk of harm. The registered person must recognise and act upon peoples rights to be provided with appropriate equipment and bathing facilities to meet their individual assessed needs. (Timescale of 30/09/07 not met) 30/04/08 Timescale for action 01/07/08 3 YA18 16 (2m) 01/07/08 Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 27 4 YA24 23 The registered person must ensure that the home is redecorated inside and that a planned maintenance programme is provided so that people live in a comfortable home that meets their needs. (Timescale of 31/8/05, 31/03/06, 30/4/06, 01/09/06 30/06/07 not met) The registered person must ensure that furnishings, fittings and equipment are of good quality and suitable for their purpose so that people live in a comfortable home that meets their needs. The registered person must provide suitable baths to ensure that all of the people that live in the home are able to have a bath if they require one. 01/07/08 5 YA24 23 01/07/08 6 YA27 13 (5) 23 (2j) 23 (2a) 01/07/08 7 YA29 13 (5) 23 (2j) 23 (2a) 8 YA39 24 (Timescale of 31/12/05, 30/4/06, 1/7/06, 30/09/06 and 30/09/07 not met) The registered person must 01/07/08 ensure that recommendations made by suitably qualified specialists (occupational therapist) are followed to ensure peoples rights to independence, safety and dignity is maintained. The registered person must 01/07/08 ensure the home’s quality assurance system is developed, and includes consultation with stakeholders, that information is collated and a written report is produced and that it is sent to the CSCI and given to the people that live in the home and their representatives. (Timescale of 9/3/05 and 31/8/05, 31/03/06, 1/6/06, 01/09/06 and 30/09/07 not met) DS0000062146.V360820.R01.S.doc Version 5.2 Page 28 Park View 9 YA42 24 The registered person must ensure that the home is able to meet all of the needs of the people that live there by providing suitable bathrooms and equipment to meet peoples individually assessed needs. 01/07/08 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 YA6 YA14 Good Practice Recommendations The registered person should ensure that care files are kept tidy and maintained in a consistent manner. The registered person should ensure that a more formal assessment is undertaken of peoples lifestyle choices, i.e. hobbies, likes/dislikes, interests and this should help to formulate their activities and lifestyle plan. The registered person should provide care plans and other documents in accessible formats. 3 YA6 Park View DS0000062146.V360820.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection 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 DS0000062146.V360820.R01.S.doc Version 5.2 Page 30 - 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. 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