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Inspection on 03/11/05 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 3rd November 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 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. They feel staff treat them well and they have opportunities to join in social activities if they want to. Residents are also given the opportunity to have their say about the service and Park View has a friendly, homely atmosphere. The numbers of care and nursing staff on duty are generally good and they appear competent, well supervised and trained. Staff recruitment practice is also good.

What has improved since the last inspection?

There has been improvement in the recording of care given to residents and records of the date that staff police checks are received are now kept. There are more domestic and catering staff and there has been an improvement in the cleanliness of the laundry. Fire alarm tests are now carried out at the required frequency.

What the care home could do better:

Nursing staff need to ensure that they sign and date any entries on residents care plans and records of staff training need to be clearer. The owners, Bothwell Ltd, need to respond more quickly to any health and safety issues raised following inspections and there needs to be an improvement in the bath and shower facilities available in the home. They also need to undertake monthly visits to gather the views of residents, relatives and staff and send reports of their findings to the Commission.

CARE HOMES FOR OLDER PEOPLE Park View Nursing Home Broad Bush Blunsdon Swindon Wiltshire SN26 7DH Lead Inspector Steve Cousins Unannounced Inspection 09:30 3 November 2005 rd 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.V256205.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 Nursing Home DS0000015936.V256205.R01.S.doc Version 5.0 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.V256205.R01.S.doc Version 5.0 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 22nd March 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. 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, who are based in South Wales, owns the home. Park View Nursing Home DS0000015936.V256205.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 9.30am and 5.00pm. There were 40 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. Comment cards about the home were also received from residents and their relatives. 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: Nursing staff need to ensure that they sign and date any entries on residents care plans and records of staff training need to be clearer. The owners, Bothwell Ltd, need to respond more quickly to any health and safety issues raised following inspections and there needs to be an improvement in the bath and shower facilities available in the home. They also need to undertake monthly visits to gather the views of residents, relatives and staff and send reports of their findings to the Commission. Park View Nursing Home DS0000015936.V256205.R01.S.doc Version 5.0 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.V256205.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 Nursing Home DS0000015936.V256205.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 and 4. Residents’ needs are assessed prior to admission and the home has the capacity to meet the needs of those admitted. EVIDENCE: The care plan of a newly admitted resident contained pre admission assessment documentation that had been completed by the manager, along with other pertinent documents. Residents were not all able to confirm that they had visited the home prior to moving in but some stated that relatives had visited on their behalf. Park View provides nursing care for the elderly and is also registered to care for up to two people with a terminal illness. From the inspectors observations and the comments of residents and relatives, it appears that the home has the capacity to meet the needs of this client group. Staff training appeared appropriate and specialist equipment and support was available where required. Where it had been identified that the home is not able to meet a resident’s needs, then appropriate action had been taken to find a more suitable placement for them. Park View Nursing Home DS0000015936.V256205.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 and 10 Residents’ needs are recorded in care plans and as far as is possible, their needs are met. They are treated with respect and their right to privacy is upheld. EVIDENCE: Care plans reviewed were satisfactory, regularly reviewed and appeared to reflect residents assessed needs. Not all documents were dated and signed. Appropriate equipment was in place and interventions carried out to meet assessed needs. The manager reported that there were no residents with pressure sores. Daily records indicated prompt response to changes in health and the involvement of GP’s and other healthcare professionals when required. The appearance of the residents’ indicated that their personal care needs were being met. Two residents stated that they would like to have a bath more often but were unable to because the bathrooms are unsuitable. The current bathing facilities are limited and this issue is dealt with in the ‘Environment’ section of this report. Twelve comment cards completed by residents indicated that they liked living in the home, felt well cared for and well treated by staff, and that their privacy Park View Nursing Home DS0000015936.V256205.R01.S.doc Version 5.0 Page 10 was respected. Comments from residents during the inspection included ‘couldn’t be better’, ‘I love it here’ and ‘the girls are wonderful’. Six comment cards from relatives indicated that they were all satisfied with the overall care provided. Indirect observation of staff indicated that they were friendly and respectful towards residents. Privacy was maintained whilst personal care is carried out. One resident did not have access to a call bell due to a safety issue. They are regularly checked by staff but expressed a wish to be able to call staff when required. Alternative methods were discussed with the manager for action. Park View Nursing Home DS0000015936.V256205.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 and 15 Residents are supported to maintain control over their lives, keep in contact with friends and relatives and there are opportunities to participate in a range of social activity both in and out of the home. Meal arrangements are satisfactory and nutritional needs are met. EVIDENCE: Two activity staff are employed and there was evidence that a high degree of internal and external activity is available. Residents spoken with were happy with the choice of activity in the home and this view was also reflected in the 13 comment cards received from residents. Residents indicated that they were able to make decisions with regard to their daily lives; such as what time to get up or go to bed and what activity they wished to get involved in. In the case of one resident, limitations to choice were only in place because of a risk to their health and safety. This had been fully discussed with the resident and the reasons documented. Visiting is between 7.00 a.m. and 11.00 p.m. Outside these hours arrangements can be made between the resident and the manager. Comment cards from six relatives indicated that they were able to visit in private and some residents confirmed this. Links with the local community were mainly via the external activities offered and the monthly church service. Park View Nursing Home DS0000015936.V256205.R01.S.doc Version 5.0 Page 12 There were positive comments from residents about the meals available. Of the comment cards received, all but three responded that they liked the food and those three replied ‘sometimes’. Residents had been asked their views about the meals in a recent questionnaire and their responses had resulted in some changes to the menu. Park View Nursing Home DS0000015936.V256205.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Complaints are taken seriously and investigated appropriately. Residents are, as far as possible, protected from abuse. EVIDENCE: A complaints procedure is available and on display. Two complaints had been recorded since the previous inspection, both of which had been dealt with promptly. No complaints have been received by CSCI. Comment cards and conversations with residents indicated that they knew who to speak to if they were unhappy with their care. The inspector spoke with a resident who was had been unhappy in the home. It was evident that strenuous efforts had been made by the manager and staff to address issues that were of concern to the resident. A procedure was in place for responding to suspicion or evidence of abuse, which is allied to local procedures. Staff receive training regarding abuse issues at induction and as part of the homes mandatory training, and the manager has an awareness of issues regarding suspected abuse. Staff recruitment records indicated that POVA and CRB checks are carried out and references sought. The arrangements for the management of residents’ money were found to be satisfactory. Park View Nursing Home DS0000015936.V256205.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20, 21 and 26 Residents have access to safe and comfortable communal areas and the home is clean and hygienic. The current bathing facilities are inadequate. 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. The property manager stated that carpets in the small lounge and adjoining corridor were being replaced. The current bath and shower facilities do not meet the requirements of all residents. The property manager agreed to install a more appropriate hoist, larger bath and complete work to install an upstairs shower room as a matter of urgency. There are adequate toilet facilities. The home was generally clean and there were no unpleasant odours. Two full time domestic staff are employed. The planned refurbishment of the laundry has yet to be completed, but the laundry was cleaner than before. Park View Nursing Home DS0000015936.V256205.R01.S.doc Version 5.0 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, 29 and 30 There are generally enough trained and competent staff to meet residents needs. Recruitment practice supports and protects the residents. EVIDENCE: Inspection of the duty rotas confirmed adherence to the staffing notice and that often, extra care staff were on duty. Residents and relatives were generally happy with the numbers of staff available. Mrs Rogers reported that levels of domestic and catering staff had improved and more cover was now available throughout the week. A selection of staff records indicated that recruitment practice was satisfactory and all required documentation was in place. Induction and mandatory training is undertaken and recorded. It was recommended that a single record is kept which would easily indicate which staff had, or had not, attended mandatory training. Five out of twenty care staff currently have an NVQ with a further five in the process of undertaking one in order to meet the target of 50 of care staff with an NVQ or equivalent qualification. Park View Nursing Home DS0000015936.V256205.R01.S.doc Version 5.0 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): 33, 36 and 38 There are systems in place to ensure residents’ views are sought; however these need to be enhanced by regular visits by the provider. Staff are appropriately supervised. Residents and staff are generally protected by the health and safety arrangements, although delays in responding to health and safety requirements may pose a risk to residents. EVIDENCE: The manager recently sent out a questionnaire to residents to monitor their satisfaction with the service. There were 29 responses and a report was produced. Residents’ meetings are also held. Unannounced monthly visits by a representative of the registered provider had not been undertaken, nor reports sent to the Commission. General staff meetings are held every six months. Records indicated that staff received regular formal supervision and annual appraisal. Park View Nursing Home DS0000015936.V256205.R01.S.doc Version 5.0 Page 17 Accidents are recorded and then reviewed monthly. There was evidence of action being taken in response to reports of accidents. Fire safety arrangements are satisfactory and essential equipment and services are regularly maintained. The manager undertakes a monthly health and safety audit. Work on installing radiator covers had not been completed despite a requirement of the previous inspection. This was discussed directly with the property manager and the work has now been completed. Park View Nursing Home DS0000015936.V256205.R01.S.doc Version 5.0 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 X X 3 3 X X 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 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X 3 2 X X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X 3 X 2 Park View Nursing Home DS0000015936.V256205.R01.S.doc Version 5.0 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 OP21 Regulation 23 (2,J) Requirement The registered provider is required to ensure that there are adequate bath/shower facilities to meet the needs of the residents. The registered provider is required to ensure that monthly visits to the service are undertaken and reports are sent to the local CSCI office. The registered provider is required to ensure that all uncovered radiators have guards fitted, or are replaced with low surface temperature models. Unmet requirement from inspection held 22/04/05. (Completed by 24/11/05) Timescale for action 22/12/05 2 OP33 26 31/12/05 3 OP38 13 (4,a,c) 03/12/05 Park View Nursing Home DS0000015936.V256205.R01.S.doc Version 5.0 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. It is recommended that alternative methods of summoning care staff be provided for the resident identified during the inspection. It is recommended that a single record be kept that easily indicates which staff had attended mandatory training. 2 3 OP8 OP30 Park View Nursing Home DS0000015936.V256205.R01.S.doc Version 5.0 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.V256205.R01.S.doc Version 5.0 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. 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