Inspection on 22/02/06 for Park View

This inspection was carried out on 22nd February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 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 Patricia Flanaghan Unannounced Inspection 22nd February 2006 11:30 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.V285041.R01.S.doc Version 5.1 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.V285041.R01.S.doc Version 5.1 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.V285041.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th September 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.V285041.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced inspection, the second visit of this inspection year, took place between 11.30pm and 4.30pm. Discussions took place with seven residents, one visitor and five members of staff. The inspection focused on the requirements arising out of the previous inspection, and the standards relating to health and safety, staffing and management. Various documents were seen during the inspection, including care plans, policies and procedures and certificates verifying training and health and safety checks. Since the last inspection on 20/09/05 there have been no additional visits made to the home and the CSCI has not received any complaints about the service. What the service does well: What has improved since the last inspection? The upgrading and refurbishment of the resident communal areas of the home has commenced with one of the dining rooms already completely refurbished. Work is ongoing in refurbishing a second dining room and providing better access to the garden areas for residents. Park View DS0000042008.V285041.R01.S.doc Version 5.1 Page 6 The home has successfully recruited a number of suitable care staff ensuring continuity of care to residents. 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.V285041.R01.S.doc Version 5.1 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.V285041.R01.S.doc Version 5.1 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): 3 All prospective residents are assessed prior to their admission to the home. EVIDENCE: The files of two residents were reviewed during this inspection. The admissions procedure for Park View included an assessment by the home completed before admission and provided the opportunity for the prospective residents and/ or their relatives to visit the home. Records showed that assessments had been completed and this provided the necessary information for the home to be able to provide the care needed. The community care plans provided by the social worker, as part of the individual needs assessment process, were seen within both care plans examined. Park View DS0000042008.V285041.R01.S.doc Version 5.1 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): 7, 8 and 9 All residents have individual plans of care, which sets out their health, personal and social care needs in detail and enable staff to ensure that these needs are met. The medicine management within the home was satisfactory but further improvements must be made to demonstrate that the residents needs are fully met. EVIDENCE: The home have comprehensive individual care plans that showed the needs of the residents. These included health needs, personal care needs, mobility and dietary needs as well as social, cultural and spiritual needs. The elements of the care plans were being reviewed and the local authority was undertaking yearly reviews that included the views of the residents and relatives. As well as reviews the home undertook weekly summaries of the care plan. The resident and relatives were involved in the care planning process. The plans included regular assessments of mobility and fall prevention. There was evidence of completed risk assessments in all the care plans examined. Risk assessments examined include nutritional risk of resident’s and the risk of a resident falling. Park View DS0000042008.V285041.R01.S.doc Version 5.1 Page 10 There is evidence in the care plans of access and advice being obtained from specialist nurses, which include District Nurses, Community Psychiatric Nurses and the GP on the care and treatment of residents. Specialist equipment and aids, which includes aids to support resident when mobilising such as wheelchairs, walking frames and hoists are available to support meeting individual needs. Five residents that were spoken with confirmed that staff treated them well and commented positively about the care they receive. Audits demonstrated that the medicines administered from the Monitored Dosage System (MDS) supplied by the community pharmacist are administered and recorded correctly. There was evidence of good stock control. The following issues were identified and discussed with the senior care officer on duty. The home did not routinely record the quantities of medicines dispensed in boxes and carried over from previous cycles so it could not be demonstrated that these medicines had been administered as prescribed. Medications transcribed by hand had not been initialled by staff. PRN medications did not consistently record the number of tablets given, for example, when the amount of medications can be one or two it should be recorded how many tablets were administered to the resident. Verbal dose changes had not been documented appropriately on the Medication Administration Records (MARs). The integrity of some of the MAR charts could not be guaranteed because there were examples of where medication had not been given yet the MAR charts had been signed to confirm that they had. A number of gaps, where a signature to confirm administration or an abbreviation for non-administration should have been, were observed. Controlled drugs were checked and records were found to be accurate. Appropriate procedures and facilities were in place to facilitate those residents who wish to continue to administer their own medication. Park View DS0000042008.V285041.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed at this inspection. Standards 12, 13, 14 and 15 were assessed as met at the inspection visit on 20/09/05. EVIDENCE: Park View DS0000042008.V285041.R01.S.doc Version 5.1 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): 18 The home has systems in place to protect residents from the risk of abuse. EVIDENCE: No incidents of neglect or abuse of any kind has been reported. The policy documentation seen, and a discussion with staff confirmed that residents are protected from all forms of abuse. Documentation seen and discussions with staff evidenced vulnerable adult protection had been discussed at length during staff induction, training and on-going supervision. Park View DS0000042008.V285041.R01.S.doc Version 5.1 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): 26 The home is clean and hygienic, with procedures in place to control and minimise the spread of infection. EVIDENCE: Redecoration and renovation of areas of the home was ongoing during the inspection visit. The dining room on the top floor has been refurbished with the dining room on the first floor currently being refurbished. The manager’s office is being moved to another area on the ground floor and direct access to the gardens is being provided. Previously, the only access to the garden was through the home’s main office and via patio doors. Some communal areas, in particular corridor walls and door frames on the top floor, continue to look grubby and shabby and although this does not pose a risk to residents, it creates a poor first impression for visitors to the home. One the day of the inspection the home was clean in resident areas and free from offensive odours. The large laundry is situated away from the kitchen and areas where food is prepared/stored. A satisfactory system is in place to Park View DS0000042008.V285041.R01.S.doc Version 5.1 Page 14 ensure that cross contamination does not occur between dirty and clean laundry. The laundry floor is impermeable and this and the wall finishes are readily cleanable. Washing machines have suitable programmes to meet disinfection standards. Park View DS0000042008.V285041.R01.S.doc Version 5.1 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): 28, 29 and 30 The recruitment procedure ensures that suitable people are employed to safely provide care for the residents. A strong commitment to training ensures staff have the knowledge and skills to undertake their duties. EVIDENCE: Staffing has stabilised since the last inspection visit with less agency staff being required to cover care shifts. This has resulted in a greater consistency of care for residents. There is a staff training plan in place and all new staff receive induction training. Training records examined show as well as the mandatory health and safety training, staff have attended regular training on the conditions associated with old age. Residents and a visitor spoken to during the inspection were full of praise for the staff. The staff files of two recently appointed staff were reviewed and indicated that the registered manager has completed all necessary recruitment checks to ensure the protection of service users. Criminal Records Bureau checks and POVA checks are maintained at head office. The home receives written verification from their Human Resources department that satisfactory checks have been obtained and this documentation is retained on individual staff files. Park View DS0000042008.V285041.R01.S.doc Version 5.1 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): 31 and 38 The overall management of the home was satisfactory. The health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: The registered manager was not on duty at the time of the inspection as she is temporarily overseeing the management of another local authority home for approximately two days a week. The registered manager has worked at the home for several years and has all the necessary skills and experience to run the home. She is supported by care officers who are on duty during the working day. Visits by a representative of the Registered Providers now take place on a regular basis and written reports are maintained, copies being forwarded to the Commission. Discussions with residents and members of staff indicate that there is improved communication in the home. People feel that they can share Park View DS0000042008.V285041.R01.S.doc Version 5.1 Page 17 their views, opinions and raise concerns and that they will be listened to and ideas and issues will be acted upon. No health and safety hazards were observed. Evidence was seen to confirm that staff receive regular training in moving and handling, fire safety, first aid, food hygiene and infection control. Fire alarm tests, emergency lighting tests and fire drills have been carried out at the required intervals. Certificates were seen during the inspection for the maintenance and service of major systems. Park View DS0000042008.V285041.R01.S.doc Version 5.1 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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 X 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 3 Park View DS0000042008.V285041.R01.S.doc Version 5.1 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 OP9 Regulation 13(2) Requirement The quantities of all medicines carried over from previous MAR charts must be recorded to enable audits to take place to demonstrate medicines are administered as prescribed. All hand written MAR charts must accurately record all the medication the service user has been prescribed, the strength of the medicines and the correct dose. A competent person should countersign all entries. Staff must refer to the Medicines Administration Record (MAR) chart before the administration of medicines and directly sign following the transaction or record the reasons for nonadministration. The MAR chart must accurately reflect what has been administered within the home. 2 OP19 23(2)(b) The registered provider must ensure that the home is kept in good decorative repair. (Part DS0000042008.V285041.R01.S.doc Timescale for action 31/03/06 31/05/06 Park View Version 5.1 Page 20 met). RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Park View DS0000042008.V285041.R01.S.doc Version 5.1 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. 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