Inspection on 09/05/08 for Park View Residential Home

This inspection was carried out on 9th May 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Park View Residential Home 10/07/07

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Park View Residential Home 70/72 Peverell Park Road Peverell Plymouth Devon PL3 4NB Lead Inspector Jane Gurnell Unannounced Inspection 9th May 2008 07:30 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 Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 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 Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park View Residential Home Address 70/72 Peverell Park Road Peverell Plymouth Devon PL3 4NB 01752 669541 01752 669541 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) Ashley Residential Care Ltd Manager post vacant Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old Age, not following within any other category: (Code OP) The maximum number of service users who can be accommodated is 20. 10th July 2007 2. Date of last inspection Brief Description of the Service: Park View is situated on the edge of Central Park, in the residential area of Peverell in Plymouth. The home is owned by Ashley Residential Care Ltd, and managed on a day-to-day basis by the 2 directors of the company. The home is within walking distance of local shops and close to Mutley Plain shopping precinct. Bus services pass the home into Plymouth City Centre. The majority of the accommodation is in single bedrooms spread over two floors with a stair lift providing access to the upper floor. Three bedrooms have ensuite toilet facilities. There are two toilets and one bathroom with a toilet on the ground floor and one bathroom with a toilet and a “walk-in” shower room and toilet (currently under construction) on the first floor. There are two lounge rooms, two dining rooms and a conservatory on the ground floor that offer sufficient and pleasant communal space. A patio area is provided at the rear of the building. Park View is registered to provide care services to older persons (OP) whose assessed care needs on admission do not fall within the categories of dementia or physical disability. The homes service is clearly defined to meet the needs of older people who have a lower level of dependence. The weekly fees at the time of this inspection ranged from £313 to £420. Items not included in the fees were hairdressing, chiropody, newspapers and magazines, clothing and toiletries. Information regarding the services provided at Park View can be obtained directly from the home. Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The inspection was unannounced and undertaken on Friday 9th May between 07:30am and 4:15pm. Both owners were present for the majority of the inspection. Prior to the inspection the Commission had sent surveys to people living in the home to ascertain their views regarding the quality of the services provided: 7 were returned and provided positive feedback about the care and support they receive. There were 13 people living in the home at the time of the inspection and 12 people were spoken with as well as the staff on duty and 3 visitors. The records relating to the care of 3 people were examined in detail, as were the records for 6 members of staff. Other documentation such as the staff and residents’ meeting minutes, quality assurance questionnaires, medication records and those relating to the fire safety precautions were also inspected. Also included in this report are the findings of three random inspections undertaken in August 2007, November 2007 and April 2008. Random inspections are undertaken to look at specific issues within the home, the two undertaken in August 2007 and April 2008 were in response to concerns raised by social services regarding the welfare of service users; the inspection in November 2007 was to monitor compliance with the requirements made at the inspections in July and August 2007. What the service does well: People said the care staff were very kind and caring and they received assistance promptly. One lady described living in the home as “excellent” and another “very nice”. All three visitors spoken to said they were impressed with the home and had a good relationship with the owners and staff. They felt confident that their relatives were well cared for and safe. The food was described as “very good” and excellent”, with plenty of choice: people particularly enjoyed the homemade pies and cakes. Parkview was generally well maintained and provided a very comfortable and attractive home. The owners have plans to ensure each room is decorated to a high standard. Standards of cleanliness were high. Living rooms were Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 6 comfortably furnished and set out in a style that encourages conversation and socialising. Outside, the rear courtyard garden provided seating areas in sun and shade where people can sit. What has improved since the last inspection? What they could do better: Closer attention needs to be paid to medication practices within the home. At the random inspections in November 2007 and April 2008 medication records were found to be incomplete which places people at risk. Care plans are the documents that records a person’s current care needs and the action required by staff to meet those needs. The information obtained through the new assessment process must to be transferred onto the care plan thereby enabling staff to have all the information to hand regarding someone’s needs, rather than having to look at several documents to obtain a full picture. Care plans must remain under review to monitor changes to health. People living in the home and/or their representatives must be involved in the development and review of the care plans. Staff must receive training in first aid, fire safety and moving and handling to ensure they have the skills necessary to keep people safe and respond to an emergency. Staff training records should be improved as it was not possible to identify which staff had current training certificates and which staff required updated training. Staff should receive formal supervision, particularly in light of the recent concerns raised over the care practices in the home. Supervision is important to ensure staff performance is in line with the home’s aims and objectives, and any training and development needs can be identified. Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 7 Repairs need to be made to an exit door to ensure the home is secure. Soiled laundry should be carried in bags or baskets and paper towels should be used in communal toilet areas to reduce the risk of cross infection. The laundry room should be cleared of unnecessary items such as paint pots to ease cleaning. 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. The summary of this inspection report can be made available in other formats on request. Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 8 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 Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5. Quality in this outcome area is good. People considering moving to Park View are provided with sufficient information to help them make an informed choice about where they live. The home’s admission process ensures that people are assessed prior to moving in to ensure that their needs can be sufficiently met. This judgement has been made using available evidence including a visit to this service. The home does not provide intermediate care EVIDENCE: Two people had recently moved into the home and both confirmed they were very satisfied with the services and support they received. Both people confirmed they had been invited to visit the home to meet the owners, staff and other people living there as well as to have a meal. One person said she and her family “were delighted by their visit to the home”. Both people said they particularly liked the fact that the home was small and had plenty of communal space: one person said it felt like being in an “ordinary” home. Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 10 Those relatives spoken with said they were kept fully informed and had confidence in the owners and staff. The pre-admission assessment for one person was examined and found to provide a clear description of her needs and how these were to be met at Park View. The assessment included information about the person’s personal and health care needs, their social and religious interests as well as their preferred routines. A Service User Guide detailing the services provided at the home and an example of the contract was provided for people considering moving in: these were also evident in people’s bedrooms. People were invited to stay in the home on a month’s trial at the end of which they can decide if they wish to stay. Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11. Quality in this outcome area is adequate. Insufficient detail in the care planning documentation places people at risk from not having their needs fully identified and met in a consistent manner. Incomplete medication administration records place people at risk from not receiving the correct medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All 12 people spoken with and the three visitors praised the quality of the care and support provided by the staff. One lady described the home is “excellent”, another person said “I am personally comfortable and happy in the home”, while others said the home was “very good” and “lovely”. Following the random inspection in August 2007 where it was identified that a person’s care plan provided insufficient detail and the person’s needs were not being fully met, the owners have introduced new care planning and assessment documentation. This documentation included assessments relating Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 12 to activities of daily living, mobility, nutritional needs, emotional and psychological well-being as well as physical health. The care plans and assessments for three people were examined in detail. Although the assessments had been completed, the information obtained had not been transferred on to the care plan. This meant that staff had to look at each assessment in order to fully identify a person’s care needs. Where a care or health need had been identified there was insufficient detail to inform staff about the support necessary to meet this need. For example it was identified that one person suffered from rheumatoid arthritis but there was no description how this affected them in their day-to-day life. Although there was some evidence that one of the owners had reviewed these plans in April 08, these were not reviewed in sufficient detail to ensure needs were being met and to monitor for signs of changing needs. For example, the review for one person discussed their changing mobility needs but not the risk from malnutrition as identified in her assessment. This person’s care plan stated that she should be weighed each month but this had not occurred since January 2008 and this was not identified in the review despite the person having lost 4 kg between October and January. The care plan should promote a person’s independence, supporting them to do as much of themselves as possible. In one care plan the person was described as needing to “wait for staff to assist with all areas of daily living” implying that this person was unable to do anything for themselves. However speaking to staff this was not the case and the care plan failed to reflect this person’s abilities, however limited. There was no evidence that these care plans had been developed in consultation with the person concerned nor their families, in fact one person was unaware that these care plans existed. On 28 April 2008, a random inspection was undertaken at the home following concerns raised by social services about medication practices. The outcome of this inspection identified that people were at risk from poor medication practices. Due to the inaccuracy of recording medicines given to people, which had been identified at the random inspections in August and November 2007, it was not possible to identify if some people had received their medication. Staff had either made no entry on the administration record or used codes to indicate that medications had not been given, however, the codes used by staff did not relate to the codes pre-printed on the administration records and staff had failed to identify what the code they had used meant. It was also noted that some medicines had not been given because the home had run out of supplies: the owners should monitor supplies of all medicines and order sufficient to cover any shortfall such as when a tablet is spoilt and cannot be given, for example if it is dropped on the floor. Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 13 Following the April 08 inspection, staff had been provided with further medication training by the local pharmacist and the owners confirmed that they would monitor practices within the home more closely. At this inspection, one person was found to have his newly prescribed medication recorded on a piece of notepaper rather then a medication administration record, spares of which were available. The care plans included a list of the medication taken by each person and either the times of day these should be taken or the reason they should be taken, but not both. It would be more useful to staff to have full information regarding the use of medication and any special precautions necessary, such as steroid medication which should not be discontinued without instructions from a GP. The District Nursing Service visits Park View to support the care staff with meeting people’s health care needs. People with terminal illnesses may remain at the home if the staff team and the District Nursing Service can continue to meet their needs and, considering the layout of the building, the home remains suitable. Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. People living at Park View were able to enjoy a relaxed, homely atmosphere where they can make choices about their lifestyle. Dietary needs were well catered for with a balanced and varied selection of food available that meets peoples’ tastes and choices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The atmosphere in the home was warm and welcoming. People were seen to be relaxing either in their rooms or with others in the communal sitting areas. People said there were no set rules in the home and they were able to make their own plans and decide when they wanted to get up and go to bed. Activities were organised by staff daily and people said how much they enjoyed these. A notice on the lounge room door gave details for forthcoming activities including tabletop games, bingo and “sing-a-longs”. People confirmed that the day before the inspection they had enjoyed a baking session making cakes and jam tarts and a sing-a-long in the afternoon. However, there was no record in people’s care notes of how they had spent to their day and whether they were involved or not in social activities. It is important to record this as, particularly Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 15 for people with short-term memory loss, it provides a record of someone’s day, provides a topic of conversation between staff, residents and family as well as records the good practice within the home. Visitors confirmed that they were welcome to visit at all reasonable times of the day and were able to join their relative for a meal at no charge. They said they had confidence in the owners and felt they were kept fully informed. People described the meals as “very good” and “excellent”. On the morning of the inspection people were seen to be enjoying a breakfast of cereals, toast, fruit and a cooked breakfast. At lunchtime, a choice of fish, peas and potatoes or ham and eggs was offered with either a milk pudding or cheesecake for dessert. The evening meal was a choice homemade quiche or sandwiches followed by homemade lemon cake. Supper was offered later in the evening and could be of peoples’ choosing. One lady said that she needed a soft diet due to swallowing difficulties and this was provided without difficulty. She said the chef “went out of her way” to ensure that she enjoyed her food. Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is good. Complaints and suggestions from those living at Park View, their relatives or other visitors to the home are treated seriously. People are listened to and issues resolved promptly. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People were asked about whether they felt they could bring concerns to the attention of the owners: without exception all those spoken with, including the three visitors, said that they had confidence in the staff and owners to deal with any issues. The home’s complaints procedure was available with a copy on the notice board in the entrance hallway as well as in the Service User Guide. The owners maintained a register of complaints/concerns brought to their attention: three complaints had been received in the past year and the action required to resolve these matters was recorded. Staff had received training in the protection of vulnerable people under the previous owners and those spoken to were aware of their responsibilities should they suspect someone is at risk. Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26. Quality in this outcome area is good. Park View is a very pleasant, generally well-maintained home that is comfortable and warm and which provides sufficient facilities to meet peoples’ needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The location and layout of the home is suitable for the needs of those currently living in the home. Previously two large houses, the home has retained much of its character and period features making it an interesting and attractive care home. The living rooms are on the ground floor and consist of two spacious lounges and a conservatory where people sit and socialise and entertain visitors. There are two well-furnished dining areas. The owners continue to invest in the property and since the previous inspection have fitted new carpets in the hallways and stairs as well as one of the lounge Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 18 and dining rooms. New tables and chairs have been provided in both dining rooms and new furniture in one of the lounge rooms. Two bedrooms have been fitted with en suite toilet facilities and one of the first floor bathrooms is currently being converted into a “walk-in” shower room and toilet. Both baths are suitable to be used to people with restricted mobility. Outside, the rear courtyard offers further space where people can sit in good weather. The area has colourful borders, plant pots and shrubs. Bedrooms are set out on two floors with a stair lift providing access to the first floor. Bedrooms seen on the day of the inspection were clean, bright and reflected the personal taste, interests and lifestyle of the individual. Doors were fitted with locks that maintained peoples’ privacy and safety of their belongings. The owners confirmed their plans to redecorate each bedroom as well as making alterations to provide further en suite facilities. Temperature control valves have been fitted to regulate water temperature from bath taps and many of the bedroom sinks, and covers have been fitted to all radiators to protect people from the risk of scalds and burns. All parts of the home seen during the inspection were found to be clean and the communal areas were free from odours. Liquid soap was provided in each toilet area to reduce the risk of cross infection from bar soap, however towels were still in use for hand drying: the owners were advised to provide paper towels for individual use. On the morning of the inspection staff were seen to be carrying wet bedding to the laundry room through the dining room. This should have been placed in a laundry bag or basket to reduce the risk of cross infection from the bedding coming into contact with the staff member’s clothing or the furniture in the dining room. The laundry room was also used as a store for paint pots and vases: this areas should be cleared of all unnecessary items to ease cleaning, again to reduce the risk of cross infection. An exit door did not close properly, thereby possibly leaving the home unsecured. The owners confirmed that a part for the lock was on order and this would be repaired as a matter of urgency. Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is adequate. Recruitment practices are not robust enough to ensure only suitable people are employed at the home. Staff training records are insufficiently detailed to ensure those staff who are employed are trained in matters relating to the care and health and safety of service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff were described by people living in the home and those visiting as very kind and caring with nothing being too much trouble. People said they were supported promptly indicating that staff were employed in sufficient numbers to meet the needs of those currently living in the home. On the day of the inspection, there were 2 care staff on duty as well as a cook and domestic staff. The duty rota indicated that 2 staff were available 24 hours a day. Catering staff work 7 days a week and the domestic staff Monday to Friday. All the staff on duty were spoken with and all said they felt well supported to undertake their work and found the owners approachable. They confirmed that the owners were available outside of office hours should they need advice or assistance. The night staff confirmed that they were under no pressure to get people up early in the morning in readiness of the day staff, and on a day of inspection only one person was up and dressed at 07:30. The personnel files for 6 staff members employed at the home were examined. All of these files contained the necessary pre-employment checks including 2 Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 20 written references and a Criminal Record Bureau Disclosure (CRB). However, records showed that the documentation for one person had been obtained after their date of employment. There was also confusion over the start date of another member of staff whose letter of appointment was dated 3 weeks after the commencement of their employment. One staff member was found to be 17 years of age, and although there is nothing to prevent someone of this age being employed in a care home they are not able to undertake personal care until they reach the age of 18. A discussion was had with this member of staff and the owners and it was apparent that this member staff had been undertaking personal care unsupervised. New staff were provided with in-house induction training to ensure they are given information about the care home and the people living there: this was evidenced in a number of staff files. The owners confirmed the staff also undertook a more formal induction programme provided by an external training company regarding the principles and values of care practice, peoples’ rights and their responsibilities towards providing a high standard of care, although none were available at the time. From the examinations of the staff files it was not easy to identify which staff had current certificates training in health and safety, fire safety, moving and handling and first aid, as some of this training was done through an NVQ training provider and certificates were not available. Two of the 6 staff files examined contained evidence that staff had received first aid training and manual handling training but one of these certificates was out of date. Training had been provided in fire safety in December 2007 and 3 of the staff whose files were examined had attended. A plan of forthcoming training events, including fire safety, was available and the owners were advised to provide a more easily audited method of identifying which staff members required updated training. Staff spoken to confirm that they had recently attended training in dementia care, the protection of vulnerable adults, as well as the recent medication training. The owners confirmed all staff either had or were in training for a National Vocational Qualification, a nationally recognised qualification for which staff must demonstrate their knowledge and skills in supporting older people. Ashley Residential Care Ltd owns another care home in Plymouth and the owners have recently employed a member of staff in the senior position of “Head of Care” to work alongside both staff and managers to oversee the quality of the services being provided. The owners believe this will address the shortfalls identified in this and other inspections with regard to care planning and medication practices as well as improving communication between the staff and the owners. Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37, 38. Quality in this outcome area is adequate. Formal management structures are not in place to ensure the quality of the services provided at Park View. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Ashley Residential Care Ltd took over ownership of Park View in March 2007 and both owners work in the home on a day-to-day basis, but are yet to register a manager for the home, although they have confirmed an application will be made by one of the owners as soon as a Criminal Record Bureau Discloser has been received. People living at home, their relatives and those staff spoken to all confirmed that the home is well managed and the owners are approachable and supportive. As identified under the outcome groups for Health and Personal Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 22 Care and Staffing, more attention from the owners is required when monitoring services within the home to ensure peoples’ need are met and practices are safe. Of the 6 staff files examined, 1 staff member had received formal supervision in September 2007 and 3 staff in January 2008. Two staff who had started to work in the home in March and April 08 had not received supervision. Although those staff spoken with said they felt well supported in their work, formal supervision is important to ensure staffs’ work performance meets the aims and objectives of the home and any issues with regard to specific care tasks and training and development can be identified. The owners had formally consulted with the people living in the home September and December 2007 and April 2008 to ascertain their views about the overall quality of the services being provided as well as ensuring peoples’ needs are being met. The results of this consultation indicated that overall people were satisfied with the services provided. In December 2007 the number of comments were made about the quality of the food and the results of the consultation in April 2008 indicated that this matter had been resolved and that people were now satisfied with the quality of the food provided. Residents and staff meetings occur every three months to ensure people are kept informed with the events of the home and future planning as well as having the opportunity to comment on the running of the home. People are encouraged to maintain responsibility for their own finances, however the home does offer safe storage for those who wish to use this. Those people spoken to said they were satisfied with this arrangement and money was available to them whenever they wanted it. The fire alarm system had been tested each week and serviced in April 08 to ensure it was in good working order: the owners confirmed that they would be upgrading the system shortly due to its age. As identified in the outcome group for Staffing, fire safety training had been provided in December 2007 to ensure staff were aware of their responsibilities should a fire arise, although not all staff had attended. Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 23 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 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 3 3 3 3 3 2 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 2 2 2 Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 24 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 OP7 Regulation 15(1)(2) (b)(c) Requirement Each person’s care plan must provide a description of how their care needs, in respect of health and welfare, are to be met. The care plan must be kept under review and revised to ensure the information is up to date. This requirement was first made at the random inspection in August 2007 and again in November 2007. 2. OP8 12(1)(a) 30/06/08 The Registered Providers must ensure the home is conducted in such a way as to promote and make proper provision for the health and welfare of those living in the home and that changes in a person’s health care needs are communicated to themselves and the staff team and that advice is sought from other health care professionals. This requirement was first made at the random inspection in August 2007 and again in November 2007. Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 25 Timescale for action 30/06/08 3. OP9 13(2) Medication records must accurately reflect whether medication has been administered and if codes are to be used, a description of what the code means must be recorded. This requirement was first made at the random inspection in August 2007 and was repeated in November 2007. 31/05/08 4. OP29 19(1)(b)( 9) (10)(a)(b) Schedule 4 (6d) The Registered Provider must ensure that staff are only employed in the home once the identified pre-employment checks have been undertaken. The records must provide an accurate record of the date employment commences. The Registered Providers must ensure staff receive training in first aid, fire safety and the moving and handling of service users. 31/05/08 5. OP30 13(4)(5) 23(4)(d) 31/08/08 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 OP9 Good Practice Recommendations The Registered Providers should ensure that there are sufficient supplies of medication in the home to prevent people from going without their prescribed medication. Care plans should detail the reason why medication has been prescribed as well as instructions to staff regarding any special precautions. Prescribed medication should be recorded onto recognised medication administration DS0000069554.V364150.R01.S.doc Version 5.2 Page 26 Park View Residential Home 2. 3. 4. OP12 OP19 OP26 5. 6. OP30 OP36 records. The Registered Providers should record people’s involvement in daily activities to demonstrate how people have spent their day. The exit door should be made secure. Soiled linen should be carried in a bag or basket, the laundry room should be cleared of unnecessary items and paper hand towels should be used in the communal toilets to prevent the risk of cross infection. The Registered Providers should review their method of recording training undertaken by staff to identify whose training is current and who requires updated training. Staff should receive formal supervision to review their work performance and practice and to identify training and development needs. Park View Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Residential Home DS0000069554.V364150.R01.S.doc Version 5.2 Page 28 - 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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