Inspection on 31/01/06 for Park View

This inspection was carried out on 31st January 2006.

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

The inspector 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 23/07/07

Park View 27/07/06

Park View 01/09/05

Park View 03/11/04

Park View 15/01/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Park View Kings Chase Witham Essex CM8 1AX Lead Inspector Diana Green Unannounced Inspection 31st January 2006 01:00 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 DS0000028381.V281926.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 DS0000028381.V281926.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Park View Address Kings Chase Witham Essex CM8 1AX 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) 01376 512443 01376 510137 parkview@runwoodhomes.co.uk Runwood Homes Plc Mrs Carol Ann Hunt Care Home 80 Category(ies) of Dementia - over 65 years of age (21), Old age, registration, with number not falling within any other category (80) of places Park View DS0000028381.V281926.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 80 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 21 persons) Service users under the Mental Health Act 1983 must not be admitted to the home The total number of service users accommodated in the home must not exceed 80 persons One service user aged 87 years with dementia whose name was made known to the Commission in August 2004 to be cared for in the OP unit Staffing levels are to be reviewed within three months from January 2005 1st September 2005 Date of last inspection Brief Description of the Service: Park View is a large fully detached purpose built two-story building situated in the centre of Witham and close to all amenities, facilities and public transport links.The home provides accommodation for up to 80 elderly people (over 65), within 4 self-contained units. The accommodation comprises 80 single bedrooms with 79 en-suite facilities. Communal facilities include 4 lounge/dining rooms, 2 lounges, quiet room and a smoking room. There is a large conservatory overlooking the local park. There are 9 bathrooms, all equipped for assisted bathing. Two passenger lifts provide access between floors, one of which can take an ambulance stretcher. Car parking for visitors is provided to the front of the building and there is an enclosed and accessible courtyard garden area. A local park is directly adjacent to the property providing some rooms with pleasant views. Park View DS0000028381.V281926.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on the 31/01/06, lasting 5 hours. The inspection process included: discussions with the manager, the deputy manager, activities coordinator, three staff, nine residents and one relative, a social worker; a tour of the premises including a sample of residents’ rooms, bathrooms, communal areas, and the laundry; and inspection of a sample of policies and records (including any records of notifications or complaints sent to the CSCI since the last inspection). Feedback was also received from a community nurse. Sixteen standards were covered, five requirements and five recommendations made. The registered manager and staff were welcoming and helpful throughout the inspection. What the service does well: What has improved since the last inspection? Since the last inspection agency staffing levels have been substantially reduced providing more continuity of care for residents. Although staffing levels could be improved, supervision of residents in the dementia unit is now closely monitored. Staff recruitment checks have been undertaken as required. Park View DS0000028381.V281926.R01.S.doc Version 5.1 Page 6 Funding has been made available for purchasing activity resources and problems with food supplies has been addressed. Hand washing facilities have been provided and some paper towel dispensers installed. A damaged carpet has been replaced as required. Systems are in place for regular cleaning of equipment. A sensory garden was being developed for 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 DS0000028381.V281926.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 DS0000028381.V281926.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): 6 This home does not provide intermediate care. EVIDENCE: This home does not provide intermediate care. Park View DS0000028381.V281926.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): 9, 10 The standard of administration and recording of medicines is generally satisfactory with prompt action taken to address any issues/incidents and ensure the safety of residents. Residents have confidence that their privacy and dignity will be upheld by the care practices and monitoring in place. EVIDENCE: From the three service users’ files inspected there was evidence that service users and/or their representative were fully involved in the assessment/development of the care plan and their signatures confirmed this. Care plans were regularly reviewed and demonstrated a good understanding of the resident’s needs with a full evaluation recorded. Risk assessments were undertaken for moving and handling, risk of falls and nutritional screening with regular monitoring of weights. Daily progress notes were generally detailed, providing evidence that residents’ needs were closely monitored. However where residents were referred to a district nurse, there was no outcome of the visit recorded and no evidence of instructions to be followed. The home had a medication policy and procedure for staff guidance. Prescriptions were seen by staff for checking prior to ordering. Medication was provided in a MDS system and stocks levels monitored. However one resident Park View DS0000028381.V281926.R01.S.doc Version 5.1 Page 10 reported delays in prescribed creams not being provided for several weeks. The manager reported this was due to a repeat prescription not being obtained. The home had two air-conditioned rooms for storage of medication; room and fridge temperatures were regularly monitored. Administration records were generally well recorded. However some omissions had no reason recorded and no description for code ‘O’ was given. Advice was given to ensure that controlled drugs have the address recorded from which they are received and the destination address on disposal/removal from the home. Medication training had been provided for care team managers since the previous inspection. Following discussion with the manager, guidance was sought from a CSCI pharmacist inspector who advised that administration of prescribed creams must be recorded by the person administering the cream. This can be recorded either on the MAR sheet or on a separate form with reference made to it on the MAR sheet. Staff were observed to knock before entering residents’ rooms and to speak respectfully to them. Residents spoken with said that staff always treated them with respect and maintained their privacy and dignity when providing personal care. Park View DS0000028381.V281926.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): 12, 13, 14 A good range of therapeutic activities is provided to a high standard in the home that provides residents with social stimulation and interaction. Visiting arrangements are open and relaxed; staff encouraged contact with the local community. EVIDENCE: The activity programme at Park View is organised by an activity coordinator supported by another part-time coordinator. Residents are assessed on admission and their preferences discussed with them. A good range of individual and group activities are provided and residents have a choice of taking part. Entertainment is also provided on a regular basis with seasonal entertainment sessions arranged with the local community. Some residents who were able attended a Rotary Club Christmas party. Residents’ individual records are maintained detailing the activity and the outcome but this could be more detailed. A resource file had been developed that included advice on personal management of residents with a dementia. An eight-week training programme in dementia care was planned for all care staff to attend. Residents spoken with said they enjoyed the musical entertainment and bingo sessions. Since the previous inspections resources have been made available for purchase of additional equipment. The activities coordinator was also in the process of developing a lottery bid for additional resources. Park View DS0000028381.V281926.R01.S.doc Version 5.1 Page 12 The statement of purpose and service users’ guide detailed the home’s policy on visiting arrangements and record of activities confirmed that links were made with the local community. Visiting was open access and several visitors were observed to visit throughout the inspection. Staff were observed to be friendly towards them and offered them a drink. All rooms were single en-suite and residents could therefore see their visitors in private or in one of the communal rooms should they wish. A church service was held each Sunday alternating between four local churches. A representative from Age Concern visited the home regularly and the home benefited from a ‘pat a dog’ scheme. The mobile library attended the home monthly. Links had recently been made with the local sixth form who attended as part of their community project and planned to visit fortnightly to take part in bingo sessions with the residents. Residents receiving respite continued to attend local day care centres whilst at the home. Residents said they were given a choice in time of getting up, in where and when to eat and in taking part in activities. All residents had a representative or advocate to act on their behalf. Information on advocacy services was displayed for their information and arranged as needed. Residents were enabled to bring in personal items including photographs, pictures and furniture subject to space. The service user guide detailed residents’ rights to access their personal care records in accordance with the Data Protection Act 1998. Park View DS0000028381.V281926.R01.S.doc Version 5.1 Page 13 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): These standard were not inspected EVIDENCE: Park View DS0000028381.V281926.R01.S.doc Version 5.1 Page 14 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): 19,26 Park View was generally safe and had a homely environment but would benefit from improved maintenance; residents’ rooms were individually furnished and equipped for their safety, comfort and privacy. The home was clean and hygienic but staff washing dishes potentially compromised infection control standards. EVIDENCE: A partial inspection of the premises was made that included communal areas, four bathrooms, a number of residents’ rooms and the laundry. Although extended and refurbished during 2003, several areas of the home had peeling wallpaper and paint damaged by equipment. Two of the residents’ kitchen/lounges inspected had units that had peeling door fronts and broken drawers. A dishwasher was broken and care staff were spending time washing dishes taking them away from their care duties and also potentially compromising infection control standards. The front entrance of the premises was strewn with litter and the garden areas were untidy and required weeding. Communal rooms were clean and well decorated and furnished to provide a Park View DS0000028381.V281926.R01.S.doc Version 5.1 Page 15 homely environment for residents. Residents spoken with said their rooms were always kept clean. The internal quadrangle garden was in the process of being cleared to establish a secure, sensory garden for residents. Records provided evidence that the building complied with the requirements of the local fire and environmental health department. The home was generally clean throughout with no malodorous smells. Liquid soap and paper towels for staff hand washing had been provided and towel dispensers purchased but were yet to be fitted. No action had been taken to install a sluice disinfector as recommended previously by an infection control nurse. This could place residents and staff at risk in the event of another outbreak of infection. The dishwasher was broken and care staff were observed washing dishes as there was insufficient crockery for replacement should it be sent to the kitchen. This potentially compromises infection control standards and also reduces the time available for care duties. The laundry was clean and well organised. However a rotary iron was out of order and a tumble drier was extremely noisy and could be clearly heard in a resident’s room above. Park View DS0000028381.V281926.R01.S.doc Version 5.1 Page 16 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): Residents’ needs are generally well met but there is no flexibility in staffing levels. This results in delays in provision of personal care and places residents potentially at risk. Recruitment practices were thorough and promoted the protection of service users. EVIDENCE: There were 79 residents at the home. Care staff on duty were confirmed at two care team managers and eleven care assistants. Residents were observed to have their personal care needs met and were generally well supervised. However due to a broken dishwasher, care staff were washing dishes in one residents’ kitchen, taking them away from their care duties. In another unit of the home there was only one care assistant supervising eight residents. This was partially due to the care assistant and others having to assist with four review meetings, although the manager had only been advised of two review meetings to be held. Residents were therefore inadequately supervised and had to wait to receive assistance with personal care. Feedback was received from two relatives who also said that there were too few staff at other times to adequately care for their loved ones, and one reported staff had told residents to ‘wait in the queue’ when they needed assistance with toileting. Park View DS0000028381.V281926.R01.S.doc Version 5.1 Page 17 Due to several staff leaving there were only six staff (14 ) with NVQ level 2 training. Agency staff had been reduced substantially in recent months, ensuring improved continuity of care for residents. The personal files of two recently appointed care staff were inspected and confirmed that all the required checks had been undertaken prior to employment. Park View DS0000028381.V281926.R01.S.doc Version 5.1 Page 18 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): 33, 37 & 38 Records required to protect residents were well maintained and up to date but not all were stored in accordance with the Data Protection Act 1998. Health and safety systems are generally well adhered to but the safety of residents and staff is compromised by shortfalls in equipment maintenance. EVIDENCE: Representatives of the organisation undertook monthly monitoring visits that were reported to the CSCI. A residents’ welcome pack was provided on admission to the home that included a service user questionnaire. Service users’ questionnaires were also distributed annually to obtain feedback on how the home was meeting their needs. Twice yearly meetings were held with relatives, providing an open forum for them to raise any concerns. An annual audit was also undertaken from which an annual plan was developed for the home that was shared with the CSCI. Park View DS0000028381.V281926.R01.S.doc Version 5.1 Page 19 Service user records were in the main stored securely in lockable facilities, however activity records detailing residents care needs were observed stored on an open desk. The home had a health and safety policy statement and there was evidence from the records and in discussion with the manager and staff generally adhered to safe working practices. All accidents, injuries and incidents were well-recorded and appropriate action taken. There had been no review/increase in storage space despite this being identified as a fire risk at the previous inspection. The conservatory of the home continued to be used to store a resident’s electric scooter as there was no other space available. However the lack of a sluice disinfector, delays in maintenance of a dishwasher, unit kitchen cupboards and fabric of the building (standard 19 & 26) place residents and staff at risk of harm in the event of accidents and outbreaks of infection. Park View DS0000028381.V281926.R01.S.doc Version 5.1 Page 20 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 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 2 x x x x x X 2 STAFFING Standard No Score 27 2 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x x x 2 2 Park View DS0000028381.V281926.R01.S.doc Version 5.1 Page 21 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 registered person must ensure that there are no delays in prescribed medication being obtained. The registered person must ensure that systems are in place for monitoring medicines administration records and reasons for omissions recorded. The registered person must ensure that cooking utensils are provided to meet the increased number of residents. This is a repeat requirement The registered person must ensure that staffing levels are provided to meet residents needs at all times and are not compromised by undertaking domestic tasks. (i.e. washing dishes) The registered person must ensure that residents’ records are stored in locked facilities. Timescale for action 31/03/06 2 OP9 13(2) 31/03/06 3 OP15 16(2) 30/04/06 4 OP27 18(1)(a) 31/03/06 5 OP37 17(1)(b) 31/03/06 Park View DS0000028381.V281926.R01.S.doc Version 5.1 Page 22 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 5 Refer to Standard OP7 OP26 OP26 OP26 OP38 Good Practice Recommendations The registered person should ensure that outcomes from district nurses’ visits are recorded and instructions followed. The registered person should ensure that a sluice disinfector is provided. This is a repeat recommendation. The registered person should ensure that the dishwasher is maintained/ replaced as necessary. The registered person should ensure that damaged kitchen units are replaced. The registered person should ensure that the tumble drier is maintained and the noise reduced. Park View DS0000028381.V281926.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 DS0000028381.V281926.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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