Inspection on 23/08/05 for Parkbrook Lodge

This inspection was carried out on 23rd August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Parkbrook Lodge 04/03/09

Parkbrook Lodge 21/03/07

Parkbrook Lodge 04/01/06

Parkbrook Lodge 28/02/05

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Park Brook Lodge Park Brook Lodge Hollington Road Stubwood Uttoxeter Staffordshire ST14 5HX Lead Inspector Sue Mullin Announced 23 August 2005 09:00 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 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 Stationary 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 Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Park Brook Lodge Address Park Brook Lodge Hollington Road Stubwood Uttoxeter Staffordshire ST14 5HX 01889 591778 01889 591778 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Voyage Ltd inc. Thelma Turner Homes Miss Sarah Louise Williams CRH 10 Category(ies) of (LD) Learning Disability registration, with number of places Park Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 28 February 2005 Brief Description of the Service: Park Brook Lodge is registered for 10 younger adults with learning disabilities. The home is a large Victorian detached house located in a rural setting between Rocester and Hollington.The building is set in well-maintained grounds and there is a large car park. The house is on 3 floors and has 10 bedrooms all with en-suite facilities, either baths or shower. There is a lounge, conservatory, dining room, activities room, kitchen, laundry, sleeping in room and office. The premises are fit for purpose and would not be suitable for persons with a severe physical disability. Suitable outdoor furniture is provided.A registered care manager and teams of development workers provide care. Health service professionals such as community psychiatric nurse, learning disability nurses, and physiotherapist are accessed when required. Two local GP practices, consultant psychiatrists and pharmacists visit the home.The home has its own multi-seat vehicle, which is extensively used for the service users. Suitable activities and events are organised and appreciated by the residents. Park Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection carried out on the 23 August 2005, information for this report was provided from discussion with staff; from conversation with residents; from observations of resident and staff interactions; from inspection of the physical environment of the establishment and inspection of care records and other documentation. At the time of this visit, several residents were out of the home with staff members on outings. Residents returned to the home later in the afternoon. There are ten residents in the home and no vacancies. The levels were adequate to meet the needs of the current client group. However, the nursing staff did not complete the care plans, care staff were expected to maintain all residents care plans. It was apparent that not all care staff had sufficient knowledge of this activity, nor the importance of it. Some work will need to be undertaken to ensure all staff completing care documents, do so in an equitable fashion, which is reviewed and audited regularly. Following discussions with the care manager it was determined that she did not appear to have enough time to undertake mandatory training and supervision for her staff. Teamwork could be strengthened; junior staff need more guidance, direction and support from management. A review of her workload should be undertaken with a recommendation that an administrator is employed in the home to deal with non-care issues. What the service does well: The service operates a person centred approach to care. Staffing levels were found to be adequate to meet the needs of residents. All residents had a healthy choice of food and stocks and supplies were plentiful. Resident’s health and personal care needs were appropriately met. Records showed that residents were supported to attend appointments with G.P’s and other health professionals. Medication records were appropriately maintained. All bedrooms were for single occupancy and exceeded the minimum standard of 10sq metres. Communal space was adequate for the needs of residents; all areas were comfortable and pleasantly decorated. Park Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: 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 Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Park Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 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 standard(s) 1,2,3,4 The homes Statement of Purpose and Service Users Guide did not provide residents and prospective residents with accurate details of the services of the home. This could inhibit people making an informed decision about the service facilities. The home demonstrated that all residents were thoroughly assessed prior to admission to the home. EVIDENCE: The service is registered to provide care and accommodation to up to 10 residents who have learning disabilities. The service does not provide accommodation for residents who have extreme physical disabilities, as there is no lift installed nor mobile hoists. The statement of purpose was very misleading in that it included facilities that were not available in the area. This was discussed at length and the care manager is to implement an accurate statement of purpose. There was no complete service users guide available, this must also be developed as discussed, included in the care records of residents and in a format that is user friendly and understood by this client group. All residents are assessed at least once by suitably trained staff and encouraged to visit the home to familiarise themselves with the other residents, staff and the homes layout. Park Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 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 standard(s) 6,7,9,10 Care plans were not all reflective of the assessed needs of residents there was poor evidence of current information. The risk assessments were not very clear and thus do not fully enable residents to take on an established role within their own care planning. EVIDENCE: The care manager and deputy manager explained to the inspector that they strived to operate a person centred approach to care, which sought to establish the wishes and aspirations of each resident. However, some care plans seen had scant outdated information contained in them, while other care plans contained more current information than others. This rather depended on which member of care was allocated to each resident. The process of assessing residents needs, developing care plans, implementing action plans and evaluating the outcomes, was not undertaken on an organised basis and improvements could be implemented to improve this situation. All care plans should be constructed by staff who have the experience and skills with working with this client group. All entries made by care staff should be countersigned and reviewed on a regular basis by the management team. Park Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 Page 10 The process of implementing Risk assessments is ongoing. The evidence of the records showed that regular monitoring and reviews were generally undertaken. Each resident’s key worker encouraged them to make decisions about their lives, and supported them to maintain contact with family and friends. The care manager’s office remains unlocked and residents care plans are not stored securely or confidences kept. This was discussed and the care manager was in the process of finding somewhere in the home where this personal information could be safely stored in a lockable facility. Park Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 Page 11 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 standard(s) 11,12,13,14,15,17 Residents are supported to be involved in regular activities and to have regular contact with families. Each resident was living a lifestyle that was appropriate to his or her individual abilities and choice. Dietary needs of residents were well catered for with a varied selection of food available that met resident’s tastes and choices. EVIDENCE: Few of the residents are able to access the community by themselves and staff provide transport and a range of regular activities such as swimming, shopping, cinema, horse riding and an annual holiday. Much time is taken up with day trips out and involvement with families and significant others. Four residents attend college, most residents at different times attend art, drama, computers, woodwork, community living sessions. Park Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 Page 12 The care manager explained that the current group of residents are highly dependent, some requiring a one to one staff ratio and maintaining community/college skills is not always what the resident chooses to be part of. All residents are encouraged to take on some daily living activities where possible. Residents and staff prepare and cook all meals and staff assist one resident to eat at meal times. Staff based upon their knowledge of residents dietary likes and dislikes and special requirements provide food choices. Residents were able to make more informed choices and participated in selection and food preparation. They were observed accessing the kitchen to make drinks and snacks (supported by staff where necessary). Most of the staff had been trained in basic food hygiene. Park Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 Page 13 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 standard(s) 18,19,20 The health care needs of residents were met and staff to ensure appropriate health monitoring and treatment, facilitated access to health services. The medication at the home was well managed promoting good health. EVIDENCE: Park Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 Page 14 During the inspection the inspector noted residents being supported in a calm and professional manner. There was good verbal and non-verbal communication evident. There was evidence in the records seen that residents health care needs were monitored and action taken by referral to the relevant health professionals. Tracking of care practice evidenced that appropriate action had been taken to ensure that a residents health care needs had been properly investigated. The records for the administration of medication were appropriately maintained, with evidence of staff signatures on each occasion medication was administered. Protocols for the administration of as required medication were in place. Some staff responsible for the administration of medication had received training and new staff would be referred for this training following a period of induction. There were no photographs of residents on the MAR sheets and no drug reference book available. These were discussed with the care manager who will ensure that these requirements are met. Park Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 Page 15 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 standard(s) 22,23 The home has a satisfactory complaints system with some evidence that residents feel that their views are listened to and acted upon. EVIDENCE: The service has a complaints procedure, but this was not displayed in the home or included in the service users guide. The care manager confirmed that she would put this procedure on display without delay. Since the last inspection the CSCI have received one complaint relating to this service. This was not upheld and the care manager spent much time and effort in resolving this issue. Procedures for the protection of vulnerable adults were in place. Some staff received training during the rolling programme of induction but this needs to be continued so that all staff have received this training. Park Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 Page 16 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 standard(s) 24,25,26,27,28,29,30 The standard of the environment within this home is good providing residents with an attractive and homely place to live. EVIDENCE: All bedrooms were for single occupancy, with appropriate furnishing and fittings. All bedrooms were seen and all very personalised and pleasant. There was plenty of space in each bedroom with good-sized ensuite facilities. Bathing and toilet facilities were in adequate numbers to meet the needs of residents. The home do not cater for residents who require a specialist bath or any other type of adaptations, however the home has a walk in shower. It was identified that all residents were risk assessed and those who required support to bathe were assisted. The hot water temperature was checked and in line with 43.C. The service has a shortage of adequate storage areas and some discussion took place with relocating the care records and medication. This will be checked on the next inspection. Park Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 Page 17 Care staff and residents undertook laundry and domestic duties. The home was clean throughout and the standards of house keeping good. Park Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,25,36 Staff morale had been affected by a recent complaint referred to CSCI. However, the senior staff in the home worked positively with residents to improve their quality of life. Key worker input varied from person to person which had a mixed effect on the desired outcomes of resident care. Not all staff have received mandatory training or formal supervision and this may have a negative effect on the standards of care provided. EVIDENCE: Park Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 Page 19 The care manager was in charge supported by the deputy manager and 7 development workers. There were 10 residents in the home, and the ages ranged from 19 to 57 yrs. The duty rosters seen evidenced that the following staffing levels had been maintained to meet the assessed needs of the residents. Early shift 7.15 – 2.45 8 development workers Late shift 2.30 – 10.00 8 development workers Night shift 9.30 – 7.30 2 development workers (1 sleeping) This time pattern allowed for constructive hand over periods. 1 housekeeper and 1 maintenance man are employed. There are no administrative hours. It is recommended that an administrator is employed in the home to deal with non-care issues. The levels were adequate to meet the needs of the current client group. The care staff were expected to maintain residents care plans but not all care staff had sufficient knowledge of this activity. Some work will need to be undertaken to ensure all staff completing care documents do so in an equitable fashion, which is reviewed and audited regularly. Evidence from discussion with staff and from the records seen indicated that some mandatory staff training had been undertaken. Training sessions need to be prioritised so that all staff receive manual handling training and regular fire drills. Although night staff have received annual fire safety training they have yet to receive any fire drills since the service was registered last year. All night staff must receive a minimum of four fire drills a year in line with fire regulations. Following discussion with the manager it was confirmed that not all care staff have received two monthly supervision. This is ongoing but needs to be developed further to avoid any gaps. Recruitment procedures were checked and all found to be in order. Park Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39,42 The health and safety of residents was compromised with the lack of night staff fire training and drills. EVIDENCE: Fire safety records were maintained, with evidence of weekly fire alarm and emergency lighting checks. Fire training had been provided to some day staff. Regular fire drills had not been carried out. This was discussed and night staff are to be prioritised for this training up to 4 times per year. Fire extinguishers had been serviced. The home have adequate insurance cover. There are no mobile hoists or bath hoists in the home. Two residents have their own wheelchairs. There are no nurse call systems in the home. One resident was engaged in conversation who was being monitored one to one due to her likelihood of absconding. She informed the inspector that ‘ I love it here – it is the best place I have been in’. Security systems were in Park Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 Page 21 place to minimise residents leaving the home unescorted and endangering themselves. This is considered very good practice by the CSCI. The care manager explained the procedures in place in the home for dealing with resident’s personal monies, this was found to be all in order. However, staff input could be minimised in this regard with the employment of an administrator, which would provide more time for the care staff to complete their management tasks. Park Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 Page 22 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 2 3 3 3 x Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 N/A 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score 2 2 2 3 1 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Park Brook Lodge Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 2 x E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 4(1)5(1) Requirement A new pertinent Statement of Purpose and Services Users Guide must be developed in line with Schedule 1 The residents care plans must be implemented to fully meet the criteria laid down in standard 6 Care pans must be maintained by competent staff. All residents confidential records must be kept safe and secure in a lockable facility. There must be current photographs of residents on the MAR sheets and a current drug reference book available All staff must receive training in line with adult protection. The complaints procedure must be on display in the home and included in the service users guide. All staff must receive mannual handling training and undergo adequate fire drills. All care staff must receive formal supervision every two months and this must be documented. Timescale for action 01/10/05 2. 6 & 32 15(1)(2) with immediate effect with immediate effect 01/09/10 3. 4. 10 20 17(1)(b) 13(2) 5. 6. 23 22 18(1)c(i) 22(5) 01/10/05 with immediate effect 01/10/05 ongoing 7. 8. 35 36 18(1)c(i) 18(2) Park Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 Page 24 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 33 Good Practice Recommendations It is recommended that an administrator is employed in the home to deal with non-care issues. Park Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 Page 25 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Brook Lodge E51-E09 Park Brook Lodge (YA) S61073 V 240691 23.08.05 STAGE4.doc Version 1.40 Page 26 - 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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