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Inspection on 14/12/05 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 14th December 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

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 Care provided at the home was observed to be good with residents offered choices and residents commented that they felt that staff listened to their concerns and comments. The commitment of the staff was evident throughout the visit and staff should be commended for their professionalism. All residents had risk assessments although these sometimes needed further updating. Residents commented that their choice of lifestyles was respected and it was clear that they were offered a wide range of leisure activities to take part in. Overall, the home was a warm and friendly environment in which several residents commented that they liked living there.

What has improved since the last inspection?

No requirements or recommendations were made at the last visit.

What the care home could do better:

Records of reviews should be made clearer to indicate where residents have been consulted about their care plans, and whether this was done at the home or by the placing Social Worker. Further work is needed to ensure thatmedication administration recording is accurate. Further improvements are needed to the existing monitoring systems used in the home so that the Registered Manager and Responsible Individual can ensure that staff are maintaining the high standards of the home.

CARE HOME ADULTS 18-65 Park View Care Home 13 Gedling Grove Nottingham NG7 4DU Lead Inspector Leslie Wilson Unannounced Inspection 14th December 2005 2:50 Park View Care Home DS0000031965.V272760.R03.S.doc Version 5.0 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 Care Home DS0000031965.V272760.R03.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 Adults 18-65. 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 Home DS0000031965.V272760.R03.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Park View Care Home Address 13 Gedling Grove Nottingham NG7 4DU 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) 0115 979 0776 0115 979 0779 Crystal Nursing Services Ltd Mrs Mary Catherine Upton Care Home 17 Category(ies) of Learning disability (17), Physical disability (17) registration, with number of places Park View Care Home DS0000031965.V272760.R03.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th June 2005 Brief Description of the Service: Park View is a home that offers nursing care for up to seventeen service users with a learning disability and some challenging behaviours. The home is situated close to the city centre, providing good links to leisure facilities, local parks, shops and public transport. The home currently provides both single and double bedrooms, a large lounge and separate dining room. There is a lawned garden to the rear of the property and car parking to the front of the home. The owner of the home has planning permission to start work to extend and upgrade the property and this work had started by the time of this visit. The home is staffed with trained nurses and care staff, who receive regular training. Park View Care Home DS0000031965.V272760.R03.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection was unannounced and started at 1450 hrs. The visit lasted 3 hours and 10 minutes during the afternoon and early evening. Six residents currently living at the Home and four members of staff who were caring for them at the time were consulted. Residents records were looked at and case tracking methods were used. Policies, procedures and the homes records were also reviewed. The home was well decorated and had the feel of a real house and not an institution. Staff and most residents seemed to enjoy being at the home and the two residents commented that the home was “very good”. Staff are generally well supported and there are sufficient systems in the home to ensure its smooth running, and that the needs of residents are met. However, some systems require some more improvement in order to meet the National Minimum Standards and information needs to be made accessible to all as appropriate. Equally due to staffing sickness pressures on staff were higher than usual, but staff should be commended for never allowing this to detract from providing the best possible service to residents. At the time of the visit the home was undergoing significant repair and refurbishment and an Application for Variation had been received by the Commission for Social Care Inspection. What the service does well: What has improved since the last inspection? What they could do better: Records of reviews should be made clearer to indicate where residents have been consulted about their care plans, and whether this was done at the home or by the placing Social Worker. Further work is needed to ensure that Park View Care Home DS0000031965.V272760.R03.S.doc Version 5.0 Page 6 medication administration recording is accurate. Further improvements are needed to the existing monitoring systems used in the home so that the Registered Manager and Responsible Individual can ensure that staff are maintaining the high standards of the home. 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 Home DS0000031965.V272760.R03.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Park View Care Home DS0000031965.V272760.R03.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Resident’s needs were assessed prior to moving into the home. EVIDENCE: Although each of the files looked at contain varying pieces of information about each resident all files contained an individual Care Plan that contained all the information indicated in standard 2.3. Files contain an assessment of residents’ needs, wishes and desires but more work is should be considered to further improve the assessment system available, to ensure that the expectations of residents are addressed. However, some residents commented that the home was a good place to live and that they had visited the home before moving into it. Park View Care Home DS0000031965.V272760.R03.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 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 and 9 Some systems were in place to ensure that resident needs were assessed but further development is needed. EVIDENCE: It was not clear if all residents had been involved in the development of their care plans as this was not always reflected in the review meeting minutes, and not all staff spoken to during the visit were sure what information needed to be included in the care plan. Some residents didn’t know whether they had a care plan. Care plan seen had evidence that they had been reviewed. It was clear from discussions with residents that they were supported in taking reasonable risks in everyday activities as part of their on-going education and development. Risk assessments although present needed fine-tuning to ensure that they identified all the on-going needs of residents. Park View Care Home DS0000031965.V272760.R03.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 15 and 17 Resident lives and lifestyle choices are respected and enriched to meet their personal needs and development. EVIDENCE: Residents commented that they used a varied range of community facilities and that ‘staff’ support them in doing this. A wide range of information was displayed throughout the home about meetings and events taking place in the local and wider community and some resident spoke about some of the information displayed. At the time of the visit a group of residents were preparing to go out for the evening and one resident was very proud of the photos and other memorabilia from previous outings and activities displayed throughout the home. Residents commented that they ‘got on’ with the neighbours. Residents were able to personalise their rooms and those residents that had already moved bedrooms following the refurbishment commented that they could have a key to their room if they could look after it without losing it. Some residents chose to stay in their rooms most of the day whilst others used one of the several lounge areas available. Private spaces were also available Park View Care Home DS0000031965.V272760.R03.S.doc Version 5.0 Page 11 for residents to meet any guests in private and it was obvious for the actions of the staff that residents’ requests for privacy within their living environment was respected and facilitated. Residents commented that they were supported in keeping in touch with their friends and families and found that the home was a ‘good place to live.’ At the time of the visit the dining room had been newly refurbished and was quite plain so that residents could help choose pictures and posters for the room. However, some residents commented that they enjoyed eating with other people and it was observed that the atmosphere was very relaxed and informal. Nutritious and varied meals were made available for residents and residents commented that they liked the meals at the home. One resident commented that he liked ‘the meals anyways but preferred them here [at the home] as I don’t have to cook them.’ Park View Care Home DS0000031965.V272760.R03.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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 Systems for the administration and recording of medication needed improvements to ensure that the health needs and safety of residents were met and maintained. EVIDENCE: A Medidose/MAR system is used in the home to ensure that resident’s medication is managed appropriately. Good records of the type of medication administered to each resident was kept but signatures were missing from some of the records of administration seen, as this had not been picked up in the monthly management checks that had taken place. This left the medication records incomplete and the system open to misuse. In discussion the Registered Manager confirmed that dual temperatures for the medication fridge were not being kept meaning that staff could not ensure that medication was being stored at the correct temperature. Park View Care Home DS0000031965.V272760.R03.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 A system is in place to ensure that residents are protected from abuse. EVIDENCE: All resident knew about to whom they could make a complaint, including the Commission for Social Care Inspection, and commented that ‘if you don’t like something you can talk to [the Registered Manager] and she will sort it out.’ Clear procedures where in place and seen, in relation to adult protection. Park View Care Home DS0000031965.V272760.R03.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 A homely environment is available which meet the needs of residents. EVIDENCE: I was given a tour of the building by the Registered Manager and in place by a resident. The Registered Manager commented that residents were able to decorate their rooms ‘to their own tastes…within reason’ and this was confirmed by observation and by the residents that were spoken to. During the visit it was necessary to ask for a wardrobe to be removed as it was blocking a fire exit and this was done immediately. Extensive refurbishment of the home was taking place at the time of the visit and although the home had walls with holes and building dust throughout residents commented that they liked the home, and the home was observed to be a warm and friendly environment. Park View Care Home DS0000031965.V272760.R03.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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 standards were not assessed at this visit. EVIDENCE: Park View Care Home DS0000031965.V272760.R03.S.doc Version 5.0 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 Systems were available but some needed further development to ensure that all staff were working to the homes high standards. EVIDENCE: It was clear from the records seen that the home was monitoring in place to ensure that services users views and comments were listened to. However, the monitoring of records needed to be improved to ensure that the correct systems were being used in the home i.e. medication records. Park View Care Home DS0000031965.V272760.R03.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 4 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Park View Care Home Score X X 2 X Standard No 37 38 39 40 41 42 43 Score X X 2 X X X X DS0000031965.V272760.R03.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? N/A 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 2 3 Standard YA6 YA20 YA39 Regulation 15 17 26 Requirement Consultation with residents about their care plans must be available for inspection. A full record of all medication administered in the home must be kept. Improved monitoring of the home must take place to ensure that system provided are being used and resident needs met. Timescale for action 30/04/06 30/04/06 30/04/06 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 YA2 YA6 YA9 Good Practice Recommendations Further work needs to take place to address all the needs of residents. Residents should be encouraged to sign their care plans to indicate that they agree with its content. Risk assessments should be reviewed to include all areas of risk and a risk management plan be developed to address the risks identified in a more comprehensive manner. Risk assessments should be regularly reviewed. DS0000031965.V272760.R03.S.doc Version 5.0 Page 19 4 YA9 Park View Care Home 5 6 7 YA20 YA20 YA22 Dual temperatures should be kept for medication fridges in accordance with the Royal Pharmaceutical Society of Great Britain Guidelines. All medication administered should be signed for. Residents money withdrawals should be signed for by the resident (if possible) and staff. 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