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Inspection on 18/10/05 for Park View (Ilfracombe)

Also see our care home review for Park View (Ilfracombe) for more information

This inspection was carried out on 18th October 2005.

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 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

The home provides a domestic and homely environment for residents to live in. All rooms have en-suite facilities. The home has a group of staff that have worked at the home for some time and the management team are well established in the home. The home ensures that all staff appointed follows the correct employment procedure to safeguard residents.

What has improved since the last inspection?

Some areas of the home have been updated and a new stair lift has been fitted which allows access to all areas of the home. The home has worked hard to update staff files and ensure that all information is obtained prior to employment.

What the care home could do better:

Assessment and care planning must improve so that staff are able to know what to do for each resident. These must be provided as a matter of priority and a further visit to the home to monitor the progress is necessary.The home must have an open atmosphere that allows residents to feel confident enough to make a complaint if they wish. Whilst redecoration and improvements to the building take place, further work must continue in some areas to make sure the home is safe and more comfortable for people who live there.

CARE HOMES FOR OLDER PEOPLE Park View (Ilfracombe) Furze Hill Road Ilfracombe Devon EX34 8HQ Lead Inspector Victoria Stewart Announced Inspection 18th October 2005 09:45 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 (Ilfracombe) DS0000022148.V250526.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 (Ilfracombe) DS0000022148.V250526.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Park View (Ilfracombe) Address Furze Hill Road Ilfracombe Devon EX34 8HQ 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) 01271 865657 Mr Andrew S Crowe Mrs Maria Crowe, Mr Geoffrey Crowe Shirley Ann Darling Care Home 22 Category(ies) of Dementia - over 65 years of age (22), Old age, registration, with number not falling within any other category (22) of places Park View (Ilfracombe) DS0000022148.V250526.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The manager must obtain the Registered Manager’s Award by 2006 The Manager must undertake NVQ 4 in care Date of last inspection 30th June 2005 Brief Description of the Service: Park View is a care home providing personal care and accommodation for 22 service users in the categories of old age (OP) and dementia, over 65 years of age (DE [E]). The home is situated in a residential area of Ilfracombe, adjacent to, and with direct access to, Bicclescombe Park. The Crowe family have run the care home over 20 years and it consists of a two storey building with a large car park situated at the rear of the property. All the private rooms are single and have en-suite facilities. There is a stairlift giving access to all areas of the home. The home has a conservatory which is sited overlooking the garden at the side of the property and a sunlounge sited to the front of the property. The home has a designated resident smoking area in the reception area at the main front entrance of the building. Park View (Ilfracombe) DS0000022148.V250526.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and is the second statutory inspection of the current year. The owner and manager were both present at the home and participated in the inspection. Any core standards not inspected on the last visit of 30 June 2005 were assessed this time. The two inspection reports should be used in conjunction with each other to get a full picture of Park View. There were 19 residents admitted on the day of inspection, 2 residents were in hospital and the home had one vacancy. The inspector looked around the building, spoke to many residents, took part in lunch and looked at a number of records. This visit concentrated on looking at staff records and resident care files, as these have been outstanding requirements. A further unannounced additional visit is planned shortly to further monitor these, as the CSCI may well have to consider taking further action is satisfactory progress has still not been achieved. What the service does well: What has improved since the last inspection? What they could do better: Assessment and care planning must improve so that staff are able to know what to do for each resident. These must be provided as a matter of priority and a further visit to the home to monitor the progress is necessary. Park View (Ilfracombe) DS0000022148.V250526.R01.S.doc Version 5.0 Page 6 The home must have an open atmosphere that allows residents to feel confident enough to make a complaint if they wish. Whilst redecoration and improvements to the building take place, further work must continue in some areas to make sure the home is safe and more comfortable for people who live there. 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 (Ilfracombe) DS0000022148.V250526.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 (Ilfracombe) DS0000022148.V250526.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): 3,6 The home’s assessment criteria needs improving and does not provide sufficient information to enable the home to be clear about whether it can meet a resident’s needs fully. EVIDENCE: Prospective residents have an assessment before their admission to the home. Three care files were looked at and these contained either an assessment provided by the local social services department or one completed by the home. The assessment criteria currently used by the home does not contain all the information required to make an informed decision about whether the needs of individual residents can be fully met by the home in order to plan care. Park View (Ilfracombe) DS0000022148.V250526.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): 7,8,9,10 Limited progress has been made on improving arrangements to ensure that the care needs of residents are identified and met. These shortfalls have a potential to place residents at risk. Medication administration at the home is well managed. Staff meets residents’ privacy and dignity needs. EVIDENCE: Individual plans of care are available but little progress has been made on the requirement to ensure that all aspects of health, personal and social care needs are identified and planned for. Three care plans were looked at. Two of these were recent admissions and the care plans had been commenced with minimum information available. One of these residents had been admitted due to a history of falls but there was no record of this or any risk assessment and associated plan with no preventative measures being taken. The remaining care plan contained some relevant information but the inspector felt that this could be more detailed. Files showed a general lack of completed risk assessments overall and information was misleading and not consistent, for example in one part of a file it stated that one resident used a zimmer frame Park View (Ilfracombe) DS0000022148.V250526.R01.S.doc Version 5.0 Page 10 and no further assistance was required and yet in another part of the file it stated that the resident was unable to walk unaided without the help of staff. The current care plan format and information held on resident files continues to be developed by the home, which has been reported in previous inspections. From observation of staff, it was seen that some needs were being addressed even though there was a lack of clear plans and guidance. The system of the administration of medicines is clear with satisfactory arrangements in place. Risk assessments, which had been reviewed, were in place for two residents who self medicate and suitable lockable space provided in their private rooms. Residents confirmed that they were treated with privacy and dignity and this was observed during the inspection. Park View (Ilfracombe) DS0000022148.V250526.R01.S.doc Version 5.0 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): 12,13,14,15 fully met the standard at the last inspection The home provides a varied menu but the times meals are served are inflexible and menus not regularly changed. EVIDENCE: Some comments received from residents regarding the type and varieties of food served at meals were passed on to the owner and manager. Meals are served at certain times and residents do not have a choice of time available. One resident was noted to be late at lunchtime for his meal and his food had been left out to get cold. He informed the inspector that this often happens. This was discussed with the owner who stated that meals were served at certain times with no flexibility. Whilst residents said that food was generally satisfactory, they complained that the food was ‘boring’ and would like to see a variety of food served on different days. Menus have not been changed for some time and show a repetition of meal. The inspector took part in lunch and the food served on that day was nutritious and appealing. Some residents would have benefited from staff assisting them to eat their meals. Park View (Ilfracombe) DS0000022148.V250526.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): 16,18 Arrangements for protecting residents from abuse are satisfactory. Some residents feel that their concerns will be listened to and acted upon. EVIDENCE: Some residents confirmed that they knew who to complain to. However, on the day of inspection one resident said that they would not feel comfortable in discussing a complaint with either the manager or owner. This was discussed by the inspector on the day and is the result of an ongoing dispute over an unrelated incident. This may eventually lead to an alternative home being found by the resident if he considers it necessary. One other resident informed the inspector of a minor issue, which she had not felt comfortable enough to complaint about. Some minor suggestions regarding food variation and type of meal served were passed to the inspector on the day and discussed (refer NMS 15). The manager has undertaken formal recognised training in the prevention of abuse and all staff are to receive training in this subject in December by an outside professional. The home has copies of the ‘No Secrets’ video and the Devon County Council Alerter’s guide which the home would follow in the case of any alleged abuse. Park View (Ilfracombe) DS0000022148.V250526.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): 19,26 fully met the standard at the last inspection There have been some improvements to the change of décor and furnishings since the last inspection but this needs to continue to create a pleasing, safe and comfortable environment for people to live in. Some of the quality of the furnishings is poor potentially placing residents and visitors at risk of injury or harm. EVIDENCE: Some areas of the home are in need of further refurbishment and broken furniture should be removed from the home. One resident was noted to be trying to sit on a broken chair before a member of staff prevented her. A new stair lift has been fitted since the last inspection given residents full access to all areas of the building. Park View (Ilfracombe) DS0000022148.V250526.R01.S.doc Version 5.0 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 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): 27,28,29,30 The home has a robust recruitment procedure which ensures that residents are protected from risk. The number and skill mix of the staff meets resident needs. EVIDENCE: Since the last inspection, the dependency levels of the residents have reduced and staff levels have increased with one full-time carer being employed. Four staff files were looked and these contained all the information required in respect of each person employed. The staff rota showed that the allocation of staff on each shift was adequate and new staff were being appropriately supervised. Residents confirmed that staff were kind and caring. Two recently admitted residents had settled in to the home with the help of staff. With the exception of two members of staff, all care staff are undertaking NVQ training. Park View (Ilfracombe) DS0000022148.V250526.R01.S.doc Version 5.0 Page 15 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, 38 fully met the standard at the last inspection 33, 35 will be assessed at the next planned visit EVIDENCE: Park View (Ilfracombe) DS0000022148.V250526.R01.S.doc Version 5.0 Page 16 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 3 2 X X X X X X X STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Park View (Ilfracombe) DS0000022148.V250526.R01.S.doc Version 5.0 Page 17 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 timescale No. 1 Standard OP3 Regulation 14 Requirement Timescale for action 12/12/05 2 OP7 15 3 OP19 13, 4 Accommodation must not be provided to residents unless their needs have been fully assessed. That assessment must be in sufficient detail to enable care staff to meet the residents’ needs. This assessment must be kept under review and having regard to any change of circumstances be revised as necessary (timescales of not met) Resident care plans must in 12/12/05 sufficient detail to provide clear guidance to staff on the actions to be taken to meet their personal, health and welfare needs. Resident care plans must be kept under review (timescale of 31.7.03, 1.12.03, 31.3.04, 10.8.04, 6.6.05 not met) Any furniture or equipment 01/11/05 which is faulty, broken or dangerous must be removed from the home in order to make the environment safe for residents to live in and remove any unnecessary hazards to their safety DS0000022148.V250526.R01.S.doc Version 5.0 Park View (Ilfracombe) Page 18 4 OP16 22 Residents must feel able to make 01/01/05 a complaint under the complaints procedure and that complaint must be fully investigated and the outcome notified to the complainant 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 Refer to Standard OP15 Good Practice Recommendations It is recommended that the home reviews the type of food served at mealtimes, varies the menus on offer and involves the residents in the process. Park View (Ilfracombe) DS0000022148.V250526.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 (Ilfracombe) DS0000022148.V250526.R01.S.doc Version 5.0 Page 20 - 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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