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Inspection on 01/03/06 for Park View Nursing Home

Also see our care home review for Park View Nursing Home for more information

This inspection was carried out on 1st March 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.

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 is good at meeting the health, social and personal care needs of its residents` and they are happy with the care and support they receive. There are enough care staff to look after people and residents feel that staff treat them well. Residents are also given the opportunity to have their say about the service and they have opportunities to join in social activities if they want to. Park View is well managed and has a friendly, homely atmosphere.

What has improved since the last inspection?

There have been some improvements to the environment with new carpets fitted and all radiators are now covered. A larger bath with a hoist has been provided on the ground floor, improving washing facilities.

What the care home could do better:

Care plans for those residents taking night sedation would help to review if sedation is needed on a long term basis and enable monitoring of any positive or adverse effects. Nursing staff need to ensure that they sign and date any entries on residents care plans As reported at the last inspection, the owners, Bothwell Ltd, need to undertake monthly, unannounced visits to gather the views of residents, relatives and staff and send reports of their findings to the Commission. Washing facilities for residents would be further enhanced if the work to install a shower on the first floor were completed. The laundry requires refurbishment to ensure that it is functional and easily cleaned.

CARE HOMES FOR OLDER PEOPLE Park View Nursing Home Broad Bush Blunsdon Swindon Wiltshire SN26 7DH Lead Inspector Steve Cousins Unannounced Inspection 1st March 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Park View Nursing Home DS0000015936.V278133.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 Nursing Home DS0000015936.V278133.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Park View Nursing Home Address Broad Bush Blunsdon Swindon Wiltshire SN26 7DH 01793 721352 01793 782647 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) Bothwells Limited Mrs Angela Jane Rogers Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41), Terminally ill over 65 years of age (2) of places Park View Nursing Home DS0000015936.V278133.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Currently registered to take one named female patient under the age of 65yrs No more than 2 persons to be in receipt of terminal care at any one time 3rd November 2005 Date of last inspection Brief Description of the Service: Park View is registered to provide nursing care for up to 41 service users aged 65 or over. The home is also registered to care for people with a terminal illness. Mrs Rogers, a registered nurse, is the manager and registered nurses are on duty at all times, supported by care assistants. Catering, laundry, housekeeping, activity, maintenance and administration services are also provided. A property manager has responsibility for the environment and health and safety. Park View is situated on the outskirts of Blunsdon in a semi-rural area within easy reach of Swindon. There is easy access from the M4 motorway and the A419, and there is also a rural bus service that runs past the home. Park View is situated in its own grounds and has accommodation on two floors. Bothwells Limited, based in South Wales, owns the home. Park View Nursing Home DS0000015936.V278133.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 9.30am and 3.45pm. There were 41 residents in the home. The findings from this inspection are based on a tour of the premises, speaking to residents, staff and relatives; and visiting frail residents. A number of records were inspected, including care plans and staff files. The findings were discussed with Mrs Rogers, the registered manager, at the end of the inspection. What the service does well: What has improved since the last inspection? What they could do better: Care plans for those residents taking night sedation would help to review if sedation is needed on a long term basis and enable monitoring of any positive or adverse effects. Nursing staff need to ensure that they sign and date any entries on residents care plans As reported at the last inspection, the owners, Bothwell Ltd, need to undertake monthly, unannounced visits to gather the views of residents, relatives and staff and send reports of their findings to the Commission. Washing facilities for residents would be further enhanced if the work to install a shower on the first floor were completed. The laundry requires refurbishment to ensure that it is functional and easily cleaned. Park View Nursing Home DS0000015936.V278133.R01.S.doc Version 5.1 Page 6 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 Nursing Home DS0000015936.V278133.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 Nursing Home DS0000015936.V278133.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): 1, 2 and 5. Standard 6 does not apply to this home. Prospective residents have the information and opportunity to make an informed decision about the home and whether it can meet their needs. Residents are issued with contracts detailing terms and conditions of occupancy. EVIDENCE: A statement of purpose and a service users guide detailing the service offered are available and further copies are held in bedrooms. A copy of the most recent CSCI inspection report was available in the foyer of the home for visitors and prospective residents to read. Potential residents are able to visit the home prior to moving in and a trial period of six weeks is offered. Terms and conditions of residence are issued to residents who purchase their care privately, and for those who are funded by local authorities. They include details of fee arrangements and allocated rooms. Park View Nursing Home DS0000015936.V278133.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. Resident’s needs are set out in an individual plan of care and their health care needs are being met. Residents are protected by the home’s systems for the handling and administration of medicines, however the monitoring of those receiving night sedation could be enhanced by the introduction of specific care plans. EVIDENCE: Care plans seen were satisfactory, regularly reviewed and appeared to reflect residents assessed needs. Care needs to be taken to ensure that assessments are dated and signed in order to evidence practice. Visits to residents’ rooms indicated that appropriate equipment was in place and interventions carried out to meet assessed needs. Daily records indicated prompt response to changes in residents’ health and the involvement of GP’s and other healthcare professionals when required. Records of wound care were good and those who are nutritionally at risk are regularly weighed. Residents spoken to were very complimentary about the support and care they received. Comments included “It’s wonderful here”, “The staff are wonderful, very kind”, “I just have to ask if I’m feeling poorly and they get the doctor for Park View Nursing Home DS0000015936.V278133.R01.S.doc Version 5.1 Page 10 me’ and “I have no complaints at all”. A record of a residents meeting also confirmed that residents thought the care was good. The procedures for the recording, storage and administration and of medicines were found to be satisfactory and there was minimal use of sedatives. The medication policy required annual review. Care plans were not always in place for those who receive night sedation, in order to review their necessity and monitor any positive or adverse effects, such as sleeping during the day or increased falls. Park View Nursing Home DS0000015936.V278133.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): 14. Residents at Park View are able to exercise choice and control over their lives and staff support them to do so. EVIDENCE: Residents confirmed that they were able to exercise some choice in how they spent their time or if they wanted to join in any social activity. One resident confirmed that they were able to stay in bed in the morning if they wished, another that they “enjoyed their own company” and that the staff respected this. Another stated, “I have everything I want and generally do as I please” and “the food’s not bad, they change it if I don’t like anything”. Social activities and outings are offered for those who wish to participate. Residents meetings are held every three months to discuss how they feel about the home, records are kept which indicated that those who attended were able to voice an opinion. There were some comments about food being not warm enough and the manager stated that action had been taken in response to this. Although standard 15 regarding meals was not fully assessed during this inspection, residents spoken with confirmed that they were happy with the meals provided. Park View Nursing Home DS0000015936.V278133.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): 16. Systems are in place to ensure complaints are listened to and dealt with appropriately and residents feel they are able to complain if necessary. EVIDENCE: One complaint had been received since the previous inspection regarding room temperature. Records indicated that this had been handled promptly and correctly. CSCI have not received any complaints since the previous inspection. A complaints procedure is available and on display. Residents spoken to had no complaints, one said they would talk to the manager if they did and another said they would tell the staff and ‘they would deal with it’. Records indicated that residents were able to voice any concerns during meetings. The manager ensures that she has open communication with residents and their relatives and this was verified by some of the residents in conversation with the inspector. Park View Nursing Home DS0000015936.V278133.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): 20, 21 and 26 Residents have access to safe and comfortable communal areas and the home is clean and hygienic. Improvements are required to the laundry. The installation of a shower on the first floor would enhance current washing facilities for residents. EVIDENCE: The home provides accommodation on two floors with three communal areas situated on the ground floor. Access to the first floor is via passenger lift or staircase. The accommodation, furniture and fittings were of a fair standard and homely in nature and some carpeting had been replaced. A maintenance person is employed and there is an ongoing programme of improvements to the decoration. Following a requirement of the previous inspection, all radiators are now covered. As reported at the previous inspection the current bath and shower facilities did not meet the requirements of all residents. The property manager had agreed to install a more appropriate hoist, larger bath and complete work to install an upstairs shower room as a matter of urgency, however this work had Park View Nursing Home DS0000015936.V278133.R01.S.doc Version 5.1 Page 14 not been completed within the required timescale of 22/12/05. Since this inspection, the manager has confirmed that the work to install the larger bath and hoist has been carried out, however the shower room has yet to be completed. There are adequate toilet facilities available to residents. The home was generally clean and there were no unpleasant odours. Two full time domestic staff are employed. Infection control procedures were in place and a copy of the HCA guidelines was available. The manager attends HCA meetings to keep updated with infection control issues. Staff were observed using disposable gloves and hand gel when appropriate. The planned refurbishment of the laundry has yet to be completed. The current laundry provides limited space and staff and manager report it is difficult to work in and keep clean. Park View Nursing Home DS0000015936.V278133.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): 27 The numbers and skill mix of care staff meets the residents’ needs and support staff are employed in appropriate numbers. EVIDENCE: Inspection of the nursing and care staff duty rotas confirmed adherence to the staffing notice with regard to numbers and skill mix, and indicated that on occasions, extra care staff were on duty. Residents spoken with felt that there were generally enough care staff available and confirmed that staff responded quickly when they rang their call bell. The inspector also observed this to be the case. The levels of domestic and catering staff also appeared appropriate and an administrator, maintenance person and two activity coordinators are also employed. Park View Nursing Home DS0000015936.V278133.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, 33 and 34 The home is well managed in the best interests of the residents and there are systems in place to ensure their views are sought; however as previously reported, these need to be enhanced by regular visits by the provider. Appropriate management and monitoring of the homes finances takes place. EVIDENCE: The homes registered manager, Angela Rogers, is a registered nurse who has worked in the home for sixteen years and who has been the matron for the last seven. Mrs Rogers had completed the Registered Managers Award and has undertaken a course in palliative care. Mrs Rogers demonstrated strong leadership and a commitment to maintaining good standards. Residents were very positive about the manager and her management of the home. Quality assurance procedures include a twice-yearly questionnaire for residents and relatives, three monthly residents meetings and audits of catering services. As reported at the previous inspection held in November 2005, Park View Nursing Home DS0000015936.V278133.R01.S.doc Version 5.1 Page 17 unannounced monthly visits by a representative of the registered provider had not been undertaken, nor reports sent to the Commission. This is requirement of the care homes regulations and every effort should be made to comply in order to avoid enforcement action by the Commission. Mrs Rodgers stated that the home was currently operating within its budget. An annual meeting is held with the homes directors to discuss financial issues and to set the budget; senior managers then regularly monitor this. A business plan has been developed and Mrs Rodgers reported good levels of communication with the management team with regard to the homes finances. Park View Nursing Home DS0000015936.V278133.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 3 3 X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X 3 2 X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 2 3 X X X X Park View Nursing Home DS0000015936.V278133.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 OP7OP9 Regulation 13 (4,c) 15 (1) Requirement The registered manager is required to ensure that all service users prescribed night sedation have a relevant care plan in place. The registered provider is required to ensure that there are adequate bath/shower facilities to meet the needs of the residents. (Requirement from the inspection held 03/11/05, met in part) The registered provider is required to ensure that the laundry is refurbished. The registered provider is required to ensure that monthly visits to the service are undertaken and reports are sent to the local CSCI office. Unmet requirement from inspection held 03/11/05 Timescale for action 07/03/06 2 OP21 23 (2,j) 01/05/06 3 4 OP26 OP33 23 (2.b) 26 01/09/06 31/03/06 Park View Nursing Home DS0000015936.V278133.R01.S.doc Version 5.1 Page 20 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations In order to evidence good practice and to adhere to the Nursing and Midwifery Council guidelines, it is recommended that all assessments and entries in care plans are signed and dated by the person completing them. Park View Nursing Home DS0000015936.V278133.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Nursing Home DS0000015936.V278133.R01.S.doc Version 5.1 Page 22 - 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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