Inspection on 12/04/05 for Parkfield House

This inspection was carried out on 12th April 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

Parkfield House 29/10/07

Parkfield House 10/04/07

Parkfield House 11/04/06

Parkfield House 12/09/05

Parkfield House 16/11/04

Parkfield House 14/06/04

Parkfield House 15/12/03

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Parkfield House Charville Lane west Hillingdon Uxbridge, Middlesex UB10 0BY Lead Inspector Rekha Bhardwa Announced 12 April 2005 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 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. Parkfield House Version 1.10 Page 3 SERVICE INFORMATION Name of service Parkfield House Address Charville Lane West, Hillingdon, Uxbridge, Middlesex UB10 0BY 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) 01895 811 199 01895 811 131 Halton Services Limites Mrs Gurbachan Kaur Sandhu Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44) of places Parkfield House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. Old Age, not falling within any other category (OP), 44 service users 2. To comply with the Minimum Staffing Notice required by the previous regulator as 31st March 2004. 3. The named service user, may be accommodated, as agreed by the Commission for Social Care Inspection on 20/8/04. The home must advise the CSCI when this service user no longer resides at the home. Date of last inspection 16/11/04 Brief Description of the Service: Parkfield House Nursing Home is a Georgian building, situated in a residential area in Hillingdon. The building has 3 storeys. It is registered to accommodate 44 service users. The building is a listed building, and is a converted mansion. There are 36 single bedrooms (spread over the ground, first and second floor) and four double bedrooms (all situated on the first floor). All bedrooms are ensuite. There are 2 sitting areas on the ground floor and one sitting area on the second floor. There is a dining room on the ground and first floor. The Home is near the local high street, public transport and local amenities. Parkfield House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection carried out as part of the regulatory process. Jane Shaw Pharmacist Inspector accompanied Rekha Bhardwa on this inspection. A total of 12 hours was spent on the inspection process. One Inspector carried out a tour of each floor of the home, and inspected service user plans, staff files and maintenance records. 10 service users, 8 visitors and 8 staff were spoken as part of the inspection process. At the time of the inspection there were only 32 service users. What the service does well: What has improved since the last inspection? What they could do better: The home must ensure that service users that are not within the category of registration are admitted. It is necessary to ensure that where bedrails are used appropriate risk assessments are completed and that this has been discussed and agreed with the service users representative. The service users plans need to be maintained to accurately reflect all the current needs of the service users and to ensure that any identified actions are carried out. All care staff must receive training in Protection of Vulnerable Adults. Parkfield House Version 1.10 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Parkfield House Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Parkfield House Version 1.10 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 standard(s) 1,2,3,4 &5. The home does not provide intermediate care. Service users and their representatives are provided with written information about the home. All service users except those receiving continuing care have a contract/agreement in place. Service users are assessed prior to admission to ensure that their needs can be met, where the service user is not within the category of registration they must not be admitted to the home, as the home would not be able to meet their specialist needs. Prospective service users and their representatives are encouraged to visit the home in order to allow them to make an informed choice. EVIDENCE: Service users, their relatives and representatives are provided with information regarding the home in the form of a Statement of Purpose and Service User Guide. Service users and relative who spoke with the Inspector confirmed that they had received this information. Parkfield House Version 1.10 Page 9 For service users funded by Social Services a main contract is in place, with individual agreements for each service user. Individual contracts are issued between the home and each privately funded service user. Where service users are receiving continuing care the Primary Care Trust had sent a letter agreeing to the placement. Pre-admission assessments were viewed on three service users files. Two Needs Led Assessments were also viewed. It was noted that on one Needs Led Assessment that the service user had a diagnosed dementia. The home is not registered to accommodate service users with dementia. The care records for this service user indicated that there was increased confusion, agitation and on occasions aggressive behaviour. Since the inspection the Registered Provider has submitted an application for Variation of Registration to include the dementia category for ten service users. The Registered Manager said that whenever possible, prospective service users are encouraged to visit the home, and meet other service users and staff. If the service user should not be able to make such a visit, the representative of the service user would also be encouraged to visit. The home does not accept emergency admissions at this time. Parkfield House Version 1.10 Page 10 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 standard(s) 7,8,9 and 10 Overall the service users plans were comprehensive and contained information on how individual needs would be addressed. Where care plans are not updated this could potentially effect how the service users needs would be met. Shortfalls in completing fully bedrail assessments could potentially place service users at risk. Where input from a specific health care professional has been identified, this must be addressed in order to meet the identified need. The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure that service users medication needs are met. EVIDENCE: Individual service users plans were available and samples were viewed on both floors. Overall these were comprehensive and detailed how the service users’ identified health, personal and social care needs would be met. Overall the service users plans were being reviewed monthly. Parkfield House Version 1.10 Page 11 It was noted that on one service users plan the arrangements for catheter care, reading the daily records indicated that the catheter had been removed but the service users plan had not been updated. Another service user plan indicated that the service user required physiotherapy, however there was no evidence that the physiotherapist had been contacted. Assessments for moving and handling, nutritional screening, skin care, risk of falling and continence assessments were in place. One bedrail assessment had not been fully completed. The records also indicated input from the GP, optician, chiropodist and other health care professionals. Wound care documentation was available, contained information on the type of dressing to be used and details of the progress of the wound. Daily records were available, signed, dated and detailed the care provided. The CSCI pharmacist Inspector undertook a full pharmacy inspection on the 12/4/05 and a separate report is available. The requirements and recommendations from that inspection have been incorporated into this report. Staff were seen to address service users in a courteous manner. Service users and visitors spoken with were generally satisfied with the care given and the attitude of the staff. Service users are encouraged to exercise choices within all aspects of their daily lives, some service users choose not to participate in activities and choose to spend time in their bedrooms rather than communal areas. Dorgards had been fitted to service users bedroom doors where they had chosen to keep their bedroom doors open. Parkfield House Version 1.10 Page 12 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 standard(s) 12,13,14 and 15 Social activities are in place and a varied activities programme is offered to service users. Visiting is encouraged for service users to maintain contact with family and friends. Service users have choices in all aspects of their daily living, these choices are well supported by the staff and enhance the quality of daily life for service users. Meal provision in the home is good offering choices, variety and catering for special dietary needs. EVIDENCE: A part-time activities coordinator is employed by the home. A weekly activities programme is displayed. External entertainers also visit the home. Service users spoken with said that they enjoyed the activities arranged, and others said that they could choose which activities they wished to participate in and that their wishes are respected. Newspapers are delivered daily to some service users. Relatives and friends were seen visiting service users throughout the day. Service users can choose to see whom they wish to see and their wishes are respected. Choices in relation to daily routines and care provision are offered to all service users. Service users spoken with indicated that choices are offered in relation Parkfield House Version 1.10 Page 13 to all aspects of their daily lives, this included where they chose to spend their time and what activities they participated in. Bedrooms viewed were personalised and several service users had their own telephones. The lunch menu was sampled on the day of the inspection; this was well presented and tasty. Menus were available and these reflected the choices that are offered. Service users spoken with indicated that they were satisfied with the meal provision in the home. Snacks and hot and cold drinks are offered to service users throughout the day. Parkfield House Version 1.10 Page 14 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 standard(s) 16,17 and 18 The home has a clear complaints procedure and service users and relatives were confident that their complaints would be listened to, taken seriously and acted upon. Lack of staff training in POVA could potentially place service users at risk of harm or abuse. EVIDENCE: The home has a detailed complaints procedure, which is freely available. Complaints records viewed clearly recorded the action taken by the home to investigate the complaint, address any shortfalls, the outcomes and copies of all correspondence. The CSCI has not directly received any complaints since the last inspection. Service users and visitors spoken with said that any concerns are taken to the senior registered nurse or the Manager and that, whenever any issues had been raised, these had been promptly addressed. The Registered Manager said that at the present time no service users had advocates, but that she would contact Age Concern in Hillingdon should the need arise. Postal votes are arranged for any service users able and wishing to vote. The home has a clear procedure for the protection of vulnerable adults (POVA), and this dovetails with the Local Authority documentation. The Registered Manager had received training in Adult Protection. Not all care Staff had received training in POVA. Parkfield House Version 1.10 Page 15 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 standard(s) 19, 20,21, 22, 23,24,25 and 26. The standard of the environment within the home is good providing service users with an attractive and homely place to live. There is evidence of ongoing maintenance and renewal of furnishings. Equipment and adaptations to meet service users needs are in place. EVIDENCE: A tour of each floor was carried out and a sample of rooms viewed. These were well maintained and had been personalised by the service user residing in the room. There are two communal lounges, a dining area and an activities room on the ground floor. On the first floor there is a lounge. There is a large garden to the rear and side of the building this was well maintained. The home has one passenger lift, which accesses all floors. Suitable adaptations were available throughout the home, communal areas and bathroom and toilet areas. The home has a call bell system and generally the calls were being answered promptly by the staff. Service users are assessed to ensure that the correct moving and handling equipment is identified. Parkfield House Version 1.10 Page 16 The assisted bathrooms and communal toilets viewed were satisfactory. There are four double bedrooms and thirty six single bedrooms and have en suite facilities to include a toilet and wash hand basin. The home was comfortably warm with satisfactory lighting at the time of inspection. Hot water temperatures are checked and recorded by the maintenance man on a monthly basis. Emergency lighting is in place and is also checked monthly, plus an external company checks and services it every 6 months. Policies and procedures for the control of infection were available. Protective clothing is provided and was seen on each floor and in the laundry. The home was clean, hygienic and odour free. Parkfield House Version 1.10 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30 Overall the systems for the recruitment of staff were robust so as to safeguard service users. Staff receive regular training and this ensures that staff have the necessary skills and knowledge to meet the service users needs. EVIDENCE: The staffing levels have been reduced by one carer in the morning as the home only had 32 service users. The Registered Manager was aware that she needed to keep staffing levels under review in order to ensure that the changing needs of service users are met. Ancillary, domestic and catering staff are employed in sufficient numbers. 5 care staff are currently undertaking the NVQ level 2 training. Induction and foundation training to meet recognised standards was in place. A training matrix had been devised, which shows when staff require to attend training and updates in mandatory training. All trained nurses had received training in the administration and management of medication. The staff employment files viewed contained details of the applicants completed application forms, medical declaration, 2 references, copies of passports, plus terms and conditions of contract. Criminal Records Bureau checks had been carried out. Two files did not contain a recent photograph and the Registered Manager said that this was in the process of being addressed. Parkfield House Version 1.10 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,35,36,37 and 38 The home is well managed and meeting the service users needs is a priority for the management and the staff team. Staff work together to meet the needs of the service users. Clear systems are in place for quality assurance so as to enhance the quality of life for service users. EVIDENCE: The Registered Manager is a First Level Nurse and has been managing the home for past three years. She is currently in the process of applying for the Registered Managers Award. She has completed periodic training. Visitors and service users spoken with were generally complimentary about the management and staff working in the home. There are clear lines of accountability within the management structure of the company. The care staff are given a copy of the General Social Care Council codes of practice. The Registered Nurses follow the Nursing and Midwifery Code of Professional Conduct. Parkfield House Version 1.10 Page 19 The notification of inspection poster was displayed. The Registered Manager and senior nurses undertake internal audits. An external audit is undertaken annually. Service users and relatives meetings take place throughout the year and service users and their relatives are encouraged to voice any issues. Regulation 26 visits are carried out and copies of the report are forwarded to the CSCI. Staff meetings take place and copies of the minutes were available. The home deals with small amounts of money for some service users and records are kept of all receipts and expenditures. Personal allowances received by the service users are not managed by the home. Where possible the service users or their representatives are encouraged to deal with the money and valuables. The home has a safe facility and receipts are given for any items given in for safekeeping. Staff supervision records were viewed and overall were found to be satisfactory. The Registered Manager was clear that supervision had to be undertaken every two months. Shortfalls in record keeping have been identified under the Health and Safety section of this report, and requirements set accordingly. Servicing records were viewed at random and were up to date. A new maintenance person had been in post for only a month . In house maintenance records were available and up to date. Parkfield House Version 1.10 Page 20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 2 3 3 3 x 3 3 3 3 Parkfield House Version 1.10 Page 21 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 4 Regulation 12 Requirement The Registered Provider must not admit anymore service users with a diagnosed dementia until his application for Variation of Registration has been agreed. The service user plans must be kept up to date and any changes must be recorded, to proveide an accurate reflection of the service users needs. Instructions received from the GP and other healthcare professionals must be acted upon. All bedrail assessments must be completed in full. To ensure that the room temperature is recorded in addition to the fridge temperature All staff working in the home must receive training in Adult Protection. A record of the training undertaken must be maintained and available for inspection. Staff records must contain the information required by the Care Homes Regulations 2001.(Previous timescale of 25th July 2004 not met) Version 1.10 Timescale for action 23/05/05 2. 7 17(1)(a) Schedules 3&4 17(1)(a) Schedule 3 13(4) 13(2) 23/05/05 3. 7 23/05/05 4. 5. 8 9 23/05/05 13/05/05 6. 18 18,13(6) 3/06/05 7. 29 19 Schedule 2 3/06/05 Parkfield House Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 9.10 9.4 9.4 Good Practice Recommendations To request a review of medication for those service users receiving celecoxib and refusing idrolax To not use sticky labels on the MAR The home should maintain the good practices achieved by regular auditing and training. Parkfield House Version 1.10 Page 23 Commission for Social Care Inspection Ground Floor 58 Uxbridge Road Ealing London W5 2ST 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 Parkfield House Version 1.10 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!