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Inspection on 10/05/05 for Park View Care Centre

Also see our care home review for Park View Care Centre for more information

This inspection was carried out on 10th May 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

Those standards inspected at the last inspection of 1 March 2005, were met and no requirements or recommendations made. Staffing has stabilised since that time although at this inspection the inspector was informed that the EMI manager and the registered manager are leaving. The process of formal staff supervision has now commenced and a training programme identified for all staff. Some senior staff have undertaken mentorship training.

What the care home could do better:

In respect of staff training, an implementation programme relating to both inhouse and formal training should now be devised and evidence provided that this is carried out. The programme should include current knowledge of medical conditions relevant to the categories of registration of the home.Staffing levels need to be very carefully monitored in order to match the needs of the residents with the number and competencies of the staff on duty.

CARE HOMES FOR OLDER PEOPLE Park View Care Centre Field View Park Farm Ashford, Kent TN23 3NZ Lead Inspector Lisbeth Scoones Unannounced 10 May 2005 11.00 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 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 Care Centre H56-H05 S26097 Park View Care Centre V223365 100505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Park View Care Centre Address Field View, Park Farm, Ashford, Kent, TN23 3NZ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01233 501748 01233 501757 Ranc Care Homes Limited Mrs Penelope Jane Barkham Care Home with Nursing 87 Category(ies) of Older People x 44; Dementia x 43 registration, with number of places Park View Care Centre H56-H05 S26097 Park View Care Centre V223365 100505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: That the manager completes the registered managers award in 2005 Date of last inspection 1.03.05 Brief Description of the Service: Park View Care Centre is an 88-bedded, purpose built two storied Home located on the outskirts of Ashford. It is set in its own grounds, surrounded by gardens and has plenty of parking spaces. The Home is registered to care for 45 Service Users requiring nursing care on the first floor and 43 Service Users who are elderly mentally infirm on the ground floor. Mrs P Barkham has been the registered manager since June 2004. She is supported by unit managers and the Director of Nursing. Following recent recruitment, there are few staff vacancies. Park View Care Centre H56-H05 S26097 Park View Care Centre V223365 100505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during the hours of 11.00 and 17.15 on Tuesday 10 May 2005 during which the inspector spoke with the manager, unit manager (nursing), 6 members of staff, 10 residents and a visitor. A partial tour of the building was undertaken and a lunch session observed at the EMI unit. Care plans and other documents were examined and discussed. An additional visit to the home was made the following day when the inspector met with the Director of Nursing. Following the inspection and receipt of an anonymous complaint, a further visit was made. What the service does well: What has improved since the last inspection? What they could do better: In respect of staff training, an implementation programme relating to both inhouse and formal training should now be devised and evidence provided that this is carried out. The programme should include current knowledge of medical conditions relevant to the categories of registration of the home. Park View Care Centre H56-H05 S26097 Park View Care Centre V223365 100505 Stage 4.doc Version 1.30 Page 6 Staffing levels need to be very carefully monitored in order to match the needs of the residents with the number and competencies of the staff on duty. 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 Care Centre H56-H05 S26097 Park View Care Centre V223365 100505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Park View Care Centre H56-H05 S26097 Park View Care Centre V223365 100505 Stage 4.doc Version 1.30 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 standard(s) 3 Residents only move into the home following an assessment of need and assurances are given that these will be met. EVIDENCE: There was written evidence that, before a place is offered, he manager or other senior member of staff visit the residents for the purpose of assessment. Park View Care Centre H56-H05 S26097 Park View Care Centre V223365 100505 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 10 A clear and consistent care planning system is in place that adequately provides staff with the up to date information to look after the residents’ needs. Residents’ health care needs are met with evidence of input from multi-disciplinary professionals. Personal care is offered in a way, which protects residents’ privacy and dignity. Residents looked well dressed and groomed. A regular hairdressing service is offered. EVIDENCE: The sample of care planning and daily records seen, provides evidence that an appropriate system of recording is used. In the EMI unit, minor recommendations for cross-referencing and dating and signing of documents were made. Care plans contain a multi-disciplinary and doctors’ page evidencing visits from the GP and health professionals (continence advisor, CPN, chiropodist, physiotherapist and others). From observations made and discussions with staff and residents, it is ascertained that residents are treated with kindness, patience and respect. Park View Care Centre H56-H05 S26097 Park View Care Centre V223365 100505 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14, 15 Designated staff are employed who regularly offer residents a range of activities suitable to their needs. Residents’ spiritual needs are accommodated. Residents’ relatives and friends are encouraged to maintain contact. The food provided is of a standard acceptable to the residents providing a choice and variety EVIDENCE: The home employs three activities coordinators. For one recently employed person training has been organised. Between them they provide activities in all units. In the EMI units mainly group activities are provided while in the nursing units these are in general on a one-to-one basis. One resident said that the activities person takes her shopping at Tesco’s. Another that he likes playing Bingo. A weekly activities programme was noted in the EMI unit. Every week musical entertainment is provided as well as a special monthly event. This was planned for the 17 July 2005 and named “Apple blossom Time”. Ashford Christian Fellowship visits every first Sunday of the month. Residents are provided with choices in respect of what wish to wear, what they would like to eat, when to get up and go to bed. Park View Care Centre H56-H05 S26097 Park View Care Centre V223365 100505 Stage 4.doc Version 1.30 Page 11 The inspector did not meet with the chef but observed lunch, consisting of lasagne with mushy or ordinary peas, carrots and mashed potatoes. One resident said she liked the puddings best and usually had two. Park View Care Centre H56-H05 S26097 Park View Care Centre V223365 100505 Stage 4.doc Version 1.30 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 standard(s) 16, 18 The complaints procedure provides residents and relatives with an opportunity to complain feeling confident that their concerns are listened to and acted upon. Through training, staff have a good knowledge and understanding of adult protection issues which protects residents from abuse. EVIDENCE: Residents spoken to said that they feel able to air their views and know who to complain to. The manager keeps a complaint log, which includes evidence that the complainant is satisfied with the outcome of the investigation. Since the previous inspection, CSCI received an anonymous complaint pertaining to perceived low staffing levels. The complaint was investigated by the Director of nursing and was not upheld. Staff are trained in all issues relating to abuse and have a good understanding as what this constitutes and would know what to do if this was ever witnessed or suspected. A notice was seen stating that a care manager holds a monthly “surgery” in the home providing advice and assistance to residents and relatives. Park View Care Centre H56-H05 S26097 Park View Care Centre V223365 100505 Stage 4.doc Version 1.30 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 standard(s) 19, 20, 21, 22, 23, 24, 25 and 26 The standard of the environment within the home is good providing residents with an attractive and homely place to live. The majority of residents said that the home was clean, pleasant and hygienic. The standard of cleanliness in one of the home’s sluice rooms was poor. EVIDENCE: The home provides a pleasant, clean and well cared for environment. No unpleasant odours were noted. A visitor said that the carpet and armchair in their relative’s room was sometimes stained and would benefit from more regular cleaning. The garden is safe and provides wheel chair access. Once planting is completed, the garden will look more colourful. A memorial feature was noted. One of the sluice rooms was in need of attention in respect of cleanliness and clinical waste management. Park View Care Centre H56-H05 S26097 Park View Care Centre V223365 100505 Stage 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 In general, staffing levels are adequate to meet the needs of the residents. Robust recruitment procedures are in place and carried out. Insufficient records are available evidencing staff training. EVIDENCE: Through recruitment and retention, the home now has a stable workforce and few vacancies exist. The home is advertising for weekend laundry staff. Staff work according to a duty rota. Staff spoken to on the EMI units said that staffing levels are adequate. In the nursing units however staff said that, at times, staffing levels are tight. Residents spoken to confirmed that, at times during the day, they had to wait for a while for the call bells to be answered. The issue of adequate staffing was discussed with the manager and the director of nursing. They confirmed that staffing levels are carefully monitored based on resident’s needs and staff competencies. The home is committed to NVQ training. A member of staff said she enjoyed the recent dementia awareness and accountability training. The nursing units manager oversees and facilitates staff training. Recent training comprises tissue viability and vena puncture. Training sessions planned comprise multiple sclerosis and use of syringe driver. A training profile was seen as well as evidence of induction, currently undertaken by 4 members of staff. It was recommended that a training matrix be maintained identifying training planned Park View Care Centre H56-H05 S26097 Park View Care Centre V223365 100505 Stage 4.doc Version 1.30 Page 15 and undertaken and that the inductee signs the induction-training programme. See also standard 36. Park View Care Centre H56-H05 S26097 Park View Care Centre V223365 100505 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36 and 38 The manager has a good understanding of the areas in which the home still needs to improve. The manager ensures that staff are aware of their roles and responsibilities. Good systems are in place ensuring that residents are asked for their views about the way the home is run. Through risk assessments and staff training, the health, safety and welfare of residents and staff are promoted, reviewed and safeguarded. EVIDENCE: Residents and staff spoken to praised the manager’s leadership and visibility. The manager has an open and transparent style of leadership. She and the Park View Care Centre H56-H05 S26097 Park View Care Centre V223365 100505 Stage 4.doc Version 1.30 Page 17 unit managers regularly work shifts over the weekend and undertake night visits to ensure consistency of standard of care. Regular staff meetings are held both at management and unit level to ensure that staff are involved with and consulted about plans for change. At this inspection, it was confirmed that the manager is leaving due to personal commitments elsewhere. The director of nursing said that a recruitment process for her replacement is under way. The manager informs the CSCI of every event reportable under Regulation 37. The director of nursing visits the home regularly and provides the CSCI with a monthly written report. Risk assessments are undertaken to ensure a safe environment and working conditions for residents and staff. Statutory training is provided to all staff in respect of fire safety awareness, infection control, first aid and food hygiene. Formal staff supervision is provided and records to that effect were seen. It was recommended that, where supervision identifies training needs, evidence is provided regarding the action taken. Park View Care Centre H56-H05 S26097 Park View Care Centre V223365 100505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x 2 x 3 Park View Care Centre H56-H05 S26097 Park View Care Centre V223365 100505 Stage 4.doc Version 1.30 Page 19 No 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 Regulation Requirement Timescale for action 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. Refer to Standard 27.1 26.1 and 26.5 30.1 and 30.2, 36.3 Good Practice Recommendations That staffing levels continue to be carefully monitored and that residents views in this respect be taken into account That a high standard of cleanliness in the sluice room identified is maintained That evidenec be provided of all statutory, in-house, specialist and other training Park View Care Centre H56-H05 S26097 Park View Care Centre V223365 100505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford, Kent TN23 1HU 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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