Inspection on 20/09/05 for Park View

This inspection was carried out on 20th September 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Park View 22/08/07

Park View 15/08/06

Park View 22/02/06

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 Patricia Flanaghan Announced Inspection 20th September 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Park View DS0000042008.V258785.R01.S.doc Version 5.0 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.V258785.R01.S.doc Version 5.0 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 Mrs Jacqueline Karen West Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Park View DS0000042008.V258785.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th January 2005 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. Park View DS0000042008.V258785.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on 20th September 2005 between the hours of 9.30am and 6.00 pm. During this time the inspector had the opportunity to meet with the residents, visitors, and staff. A tour the home was undertaken and documents relating to the residents and the management of the home were examined. The registered manager was fully involved in the inspection process. As part of the inspection process, questionnaires were distributed to residents, relatives and visitors to the home for their views on how care is provided in the home. As a result of this, 28 written comments and 3 telephone messages were received by the commission prior to this inspection, eleven of these comment cards were from residents. Some comments were positive about the standard of services at the home, for example, a relative advised “I am happy with the standard of care provided at Park View.” One of the questions asked of residents was “Do you feel well cared for?; all residents responded positively to this question. Four residents would like more activities to be available and three said they sometimes did not like the food. Most residents commented that, in the main, the staff treat them well, with eight comments from both residents and relatives expressing concern at the high number of agency staff working in the home. Detailed feedback was given to the manager on the day of the inspection visit. What the service does well: What has improved since the last inspection? The statement of purpose has been amended to reflect the range of needs the home caters for. The windows in the home have been checked and any that did not fully close have been repaired. Park View DS0000042008.V258785.R01.S.doc Version 5.0 Page 6 The lighting in some of the communal areas have been upgraded to meet recognised standards. This work remains ongoing. Plans have been drawn up to arrange easy access for residents and their visitors to the back garden. 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.V258785.R01.S.doc Version 5.0 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.V258785.R01.S.doc Version 5.0 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): 5 Residents and or their families have the opportunity to visit the home in order to decide the suitability, quality and the facilities of the home. EVIDENCE: The home ensures that prospective service users and/or their families have the opportunity to assess the suitability of the home before making a choice of home and a trial stay before they make a decision to stay. Discussions with staff evidenced that it was part of the home’s admissions procedure to provide the opportunity for the prospective residents and/ or their relatives to visit the home. Several residents spoken with confirmed that either they or their relatives had visited the home prior to admission. A relative of another resident visiting at the time of the inspection said that they had visited the home before their relative moved in. Park View DS0000042008.V258785.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 10 Residents are treated with dignity and respect and their right to privacy is upheld. EVIDENCE: Residents stated that they felt they received good care and that the staff were caring and respected their privacy and dignity. Five residents said that that staff always knock on bedroom doors and wait to be invited in before entering. Throughout the inspection staff were seen to knock on residents’ doors before entering, offer choices and ensure that all personal care and consultations are conducted in private, this assists in maintaining the residents privacy and dignity. Four residents spoken to said that permanent staff are kind and friendly, two advising that they sometimes found it difficult to understand some agency staff. Two comment cards received from residents prior to the inspection advised that staff treat them well ‘sometimes.’ Park View DS0000042008.V258785.R01.S.doc Version 5.0 Page 10 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 and 15 Residents are supported in some areas of their daily lives including having nutritionally well balanced appetising meals and keeping in contact with important people in their lives. The activities provided within the home generally meet service users’ expectations, interests and needs. EVIDENCE: The home provided details of a basic activity programme that take place on a daily basis. Some comment cards received from relatives and residents expressed a wish for the activity arrangements to be improved with one resident asking if the home could have more use of the mini bus for outings. On the day of inspection residents were seen to be involved in a ‘sing a long’ session and some had a manicure in the afternoon. Monthly church services are held in the home. The home provided flexible routines whereby residents could get up and go to bed when they wished, could spend time in the communal rooms or in their bedrooms and could choose where to have meals and snacks. Breakfast could be taken at a time of the residents choosing. This was also confirmed during conversations with residents. Park View DS0000042008.V258785.R01.S.doc Version 5.0 Page 11 Visitors could visit at any reasonable time and those spoken with during the inspection visit advised that they were made to feel welcome. Several residents went out of the home regularly, one resident advising that she shops in the near by town centre most weekends. The home provided a varied menu and provided choices at all meals. Meals are served in the dining area within each separate unit or in residents own rooms if preferred. Each unit has a kitchenette with a fridge, freezer, microwave and dishwasher. Meals are sent up in a heated trolley from the kitchen. Each unit has their own supply of cutlery and crockery. A meal was shared with residents and this was tasty and nutritious. Residents were in the main complimentary about the standard of food provided. Two residents said that the quality of the meals sometimes varies, but there is usually something on the menu they can eat. Three written comments from residents received prior to the inspection also expressed that they do not always like the food. Staff were seen to assist residents, however, one resident with sight impairment would like more help at mealtimes. An inspection of the dining areas on all floors demonstrated that they need refurbishment, as at present they not provide a very pleasant setting for dining in. Park View DS0000042008.V258785.R01.S.doc Version 5.0 Page 12 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 Procedures are in place to ensure that complaints are dealt with promptly, in a structured manner, objectively and within stated timescales. EVIDENCE: A detailed complaints procedure is available and accessible to residents, staff and visitors in the home. Relatives spoken with advised that they would speak to the manager or other staff if they had any concerns. The Commission have not received any complaints since the last inspection. All concerns received at the home had been recorded and responded to appropriately. However, it was not always clear when a complaint had been satisfactorily concluded. Park View DS0000042008.V258785.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23 and 24 Improvement to the décor, furniture and fittings is necessary to provide the people living in the home with a comfortable, bright and homely environment. EVIDENCE: There has been no change to the decor or furnishings for a number of years and although this does not pose a risk to residents shared areas of the home do not create a pleasing and pleasant environment to live in. The walls and door frames in corridors on all floors were marked and scuffed. The corridor on the top floor in particular is very grubby and requires urgent re-decoration to make it more homely and welcoming. The environmental shortfalls creates a poor first impression for visitors. Individual bedrooms had been personalised with residents having brought in personal items and effects from home. The majority of bedrooms require redecoration with torn or faded wallpaper evident. Water stains on the wallpaper Park View DS0000042008.V258785.R01.S.doc Version 5.0 Page 14 were clearly evident in one bedroom and the carpet in another bedroom was noted to require cleaning. All bedrooms have an en suite toilet and wash hand basin. There are sufficient toilets and assisted bathing facilities near communal areas. The home has a rear walled garden which is not easily accessible to residents and their visitors. The only access to the garden is through the home’s main office and via patio doors which are not easy to open. Two comment cards received asked for the garden to be more accessible and the manager advised that plans for alterations to enable easy access to the garden have been submitted to the county council. Park View DS0000042008.V258785.R01.S.doc Version 5.0 Page 15 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 The numbers and skill mix of staff generally meets the needs of residents living in the home. The home is experiencing a period of instability with staffing and ongoing difficulties in recruitment of local staff. EVIDENCE: It was evidenced from duty rotas and the number of staff on duty at the time of inspection that sufficient core staff are available to support the services provided by the home. There is, however, an over reliance of agency staff to cover shifts that the home are unable to fill with their own permanent staff. A number of residents spoken to said that the home often uses agency staff which they are unhappy about. Permanent staff were praised for their hard work, but two residents said they have difficulty understanding some of the agency staff for whom English may not be their first language. Eleven comment cards were received from residents and visitors expressing concern at the high numbers of agency staff sometimes working in the home at any one time. Two staff said that weekends were difficult to maintain cover with permanent carers and occasional problems were being experienced with ensuring sufficient and suitability qualified agency staff are available. Where possible the manager uses the same agency carers to provide a greater consistency of care. The manager advised that Park View, in common with many other homes, was experiencing problems in recruiting suitable permanent staff to fill present vacancies. Park View DS0000042008.V258785.R01.S.doc Version 5.0 Page 16 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): 32, 33 and 35 While there is a management structure in place within the home, feedback from residents, visitors and staff indicate that staff morale is low and this may be a reflection on the staffing imbalance. Records detailing how resident’s monies are handled are maintained confirming that residents are safeguarded from financial harm. EVIDENCE: Discussions with staff on duty on the day of the inspection visit evidenced that there appears to be issues that needs to be resolved between staff and the management team within the home. It was also apparent that these issues had not been raised appropriately or conflicts resolved. Some questionnaires completed by visitors also highlighted the tensions felt within the home between staff and management, one comment being that “the staff work very hard, but morale is very low at the moment.” The manager is arranging to meet collectively or individually with all members of staff in the home to Park View DS0000042008.V258785.R01.S.doc Version 5.0 Page 17 resolve any concerns they may have. next inspection visit. This standard will be followed up at the The residents’ views of the home and the care provided are obtained annually and the results are published within the home. It would be beneficial for this quality assurance system to be expanded to include the views of families, friends and professionals involved in the residents’ lives and the home. Monies on behalf of residents are held in a central account by the county council. Cash is pooled together in one amount at the home, therefore residents individual cash balances could not be checked. A separate record is maintained for each resident which details their individual balance. The total amount tallied with what had been recorded on the central account. The recommendation of the previous inspection that residents monies should be kept individually in the home and not pooled in one envelope is carried forward. Park View DS0000042008.V258785.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 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 X 2 2 3 X 3 2 X X STAFFING Standard No Score 27 2 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 2 3 X 3 X X X Park View DS0000042008.V258785.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 OP19 Regulation 23(2)(b) Requirement The registered provider must ensure that the home is kept in good decorative repair. (Previous timescale of 30/09/04 and 06/01/05 not met). The registered manager must continue to pursue a solution for ensuring residents have safe and easy access to the back garden. The odour in the individual room must be attended to and the carpet cleaned where necessary. Each service user must have a lockable storage space for medication, money, and valuables and should be provided with a key which he or she can retain. If a resident declines lockable storage, this should be recorded on their individual records. (Previous timescale of 30/04/05 not met) The registered manager must ensure that at all times sufficient trained staff are on duty to meet the needs of residents accommodated in the home. Timescale for action 31/12/05 2 OP20 13(4), 23 31/12/05 3 4 OP24 OP24 16(2) 16, 23 31/10/05 31/12/05 5 OP27 18 (1)(a) 31/10/05 Park View DS0000042008.V258785.R01.S.doc Version 5.0 Page 20 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 3 4 Refer to Standard OP12 OP16 OP32 OP33 Good Practice Recommendations It is recommended that activities are organised to suit the individual needs of residents. It is recommended that the outcome of any investigation into a complaint is recorded in the complaints register. The manager will need to address the staff morale at the home and it is recommended that further staff meetings be held in relation to this. The home should consider regularly seeking the views of residents, relatives and other stakeholders on how the home is achieving goals for the residents, as well as undertaking the annual satisfaction survey. Residents monies should be kept individually in the home. (Recommendation carried forward from 06/01/05. 5 OP35 Park View DS0000042008.V258785.R01.S.doc Version 5.0 Page 21 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.V258785.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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