Inspection on 12/09/05 for Parkfield House

This inspection was carried out on 12th September 2005.

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

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

Other inspections for this house

Parkfield House 29/10/07

Parkfield House 10/04/07

Parkfield House 11/04/06

Parkfield House 12/04/05

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 Mrs Rekha Bhardwa Unannounced 12 September 2005 @ 09:50am 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 G61-G10 s10935 Una Parkfield House v214439 120905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Parkfield House Address Charville Lane West Hillingdon Middlesex UB10 0BY Uxbridge 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 811199 01895 811131 Halton Services Limited Mrs Gurbachan Kaur Sandhu CRH Care Home with Nursing 44 36, DE Dementia 8 Category(ies) of OP Old age registration, with number of places Parkfield House G61-G10 s10935 Una Parkfield House v214439 120905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Old Age, not falling within any other category (OP) 36, Dementia (DE) 8 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. 4. Staffing levels in the Dementia Unit must at all times be maintained at 1 RMN (or RN with appropriate post qualification training in dementia care) and 1 Care Assistant unless negotiated and agreed with the relevant regulating authority in advance of any change being made. Date of last inspection 12/04/05 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.Since the last inspection the home has opened a new 8 bedded dementia care unit on the first floor. Parkfield House G61-G10 s10935 Una Parkfield House v214439 120905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken by Mrs Rekha Bhardwa. A total of 7.10hrs was spent on the inspection process. The Inspector viewed staff records, service user records, maintenance records, the business and financial plan for the home. A brief tour was also undertaken this also included the external grounds. The Inspector spoke with eight staff, two visitors and six service users during the course of the inspection. It must be noted that it is sometimes difficult to ascertain the views of service users with dementia care needs. The dementia unit had been open for a month at the time of the inspection. This unit will be fully assessed at the next inspection. Thirty six of the thirty eight standards were assessed at the announced inspection. The primary purpose of this inspection was to assess the progress made with the requirements from the last inspection and to assess the two standards which were not assessed at the announced inspection. What the service does well: What has improved since the last inspection? What they could do better: Whilst there had been improvements in the care plans there were still some shortfalls that needed to e addressed. Where a need has been identified this Parkfield House G61-G10 s10935 Una Parkfield House v214439 120905 Stage 4.doc Version 1.40 Page 6 must be reflected in the care plan. Bedrail and lap strap assessments must be completed in full. This was a requirement from the last inspection. Where input from another professional has been identified this must be available to the service user. Shortfalls in the staffing of the laundry must be addressed. All staff must receive regular fire drill training, this includes night staff. Where the home receives a needs led assessment the Registered Manager must ensure that this is up to date. Further work must be undertaken in ensuring that the service users wishes around death and dying are discussed and recorded. 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. Parkfield House G61-G10 s10935 Una Parkfield House v214439 120905 Stage 4.doc Version 1.40 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 G61-G10 s10935 Una Parkfield House v214439 120905 Stage 4.doc Version 1.40 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 and 3. The home does not have an intermediate care unit. Service users are provided with information about the home, so as to be clear about the services the home provides to meet their needs. Shortfalls in identifying that needs led assessments provided by the placing Social Worker are not up to date potentially do not identify the current needs of the service user. EVIDENCE: The Statement of Purpose and Service User Guide had been updated to incorporate the new dementia unit. Service users records viewed during the inspection indicated that they had been assessed prior to moving into the home. For one service user that had moved from another nursing home, the needs led assessment completed in November 2004 had been used by the Social Worker, there was no evidence that this had been updated prior to the service user moving to Parkfield House. Parkfield House G61-G10 s10935 Una Parkfield House v214439 120905 Stage 4.doc Version 1.40 Page 9 There was evidence in the files viewed that the senior staff within the home undertook a comprehensive pre-admission assessment. Staff had working on the dementia unit had received training in dementia care. Parkfield House G61-G10 s10935 Una Parkfield House v214439 120905 Stage 4.doc Version 1.40 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,&11 Where input from a specific health care professional has been identified, this must be addressed in order to meet the identified need. Service users individual needs were not always identified and information held was not always up to date, and this can place service user at risk of not having their needs fully met. All lap strap and bedrail assessments must be completed in full, in order that service users are safeguarded. The medication systems in place are well managed and promote good health. EVIDENCE: A sample of service user plans were viewed by the Inspector. The home uses pre-written care plans with various headings. Care plans on the service users dementia needs were not in place, the Registered Manager was aware of this One service user had identified needs in relation to catheter care and incontinence however there was no service user plan in place for these needs. Care plans were being reviewed monthly. The care plans on how service users dementia needs will be met must be in place. Parkfield House G61-G10 s10935 Una Parkfield House v214439 120905 Stage 4.doc Version 1.40 Page 11 Risk assessments on moving and handling, skin integrity, the risk of falls, and nutrition were available. For one service user who required a lap strap the assessment as to why this was required was not complete. For another service user the bedrail assessment did not identify the clear reasons why the bedrail was required. One risk of falling assessment indicated that physiotherapy input was required. There was no evidence that this had taken place. All service users were registered with a GP. Service users had access to primary health care treatments. The service users medication administration records were viewed and well recorded. A waste disposal bin for the disposal of medication had been ordered. It was discussed with the Registered Manager the need to update the medication policy and procedure to incorporate the new waste regulations in relation to medication. A form for service users bereavement wishes is used by the home. In some instances this had not been completed. The Registered Manager stated that some relatives/service users did not wish to discuss this when approached with the subject. The Inspector discussed the need for staff to record this. The changing needs of service users are kept under review and the staff commented that for many service users in there last days do not want to go to hospital. This is discussed with the family and GP. Parkfield House G61-G10 s10935 Una Parkfield House v214439 120905 Stage 4.doc Version 1.40 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) 15 Dietary needs of service users are well catered for with food choices provided and food available that meets service users preferences. EVIDENCE: Menus were available and reflected choices. Service users spoken with said in general the meal provision was satisfactory and that they are offered choices. Clear lists of the service users diets were available in the kitchen. The kitchen was viewed at this inspection. The required records were available and cleaning schedules were being followed. Food was appropriately stored in the fridge and freezer. Drinks and snacks are offered throughout the day. The Inspector noted that the kitchen floor was worn and that its replacement or renewal was required. Parkfield House G61-G10 s10935 Una Parkfield House v214439 120905 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The home has clear complaints procedures in place to address any concerns raised by service users and their visitors. Systems are in place for the protection of vulnerable adults, so as to protect them from possible risk of harm or abuse. EVIDENCE: A complaints policy and procedure were available. The CSCI had received one anonymous complaint in July 2005. An additional visit to investigate this complaint was undertaken. One element of the complaint was partially substantiated and a requirement and recommendation were made. The Inspector was informed that staff had received training in the Protection of Vulnerable Adults. There have been no POVA issues reported to the Commission. Parkfield House G61-G10 s10935 Una Parkfield House v214439 120905 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 The home is generally clean and tidy and the environment is safe for service users. This provides the service users with a comfortable and safe environment for those living and visiting. Systems were in place for infection control in order to safeguard service users from infection. EVIDENCE: A brief tour of the home was undertaken. There was in place an ongoing programme of redecoration. The inspector noted that there were signs of wear and tear to doorframes and woodwork. The rooms viewed were generally well maintained, clean and hygienic. The dementia unit has been fitted with a keypad system to ensure the safety of the service users. Work had been in progress on the secure garden for the service users with dementia. This was almost complete. The grounds were well maintained and seating was available for service users. Parkfield House G61-G10 s10935 Una Parkfield House v214439 120905 Stage 4.doc Version 1.40 Page 15 The home was clean and odour free in the service users areas. The laundry room was in the process of being redecorated following a fire. The Inspector noted that the laundry was not to be done until the afternoon. Malodours were present in this area. Staff were observed to have access to gloves, aprons and paper towels. Parkfield House G61-G10 s10935 Una Parkfield House v214439 120905 Stage 4.doc Version 1.40 Page 16 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 and 29 Overall the systems for the recruitment of staff were robust so as to safeguard service users. Insufficient staff in the laundry does not meet the laundry needs of the service users. EVIDENCE: The dementia unit had been open for one month. At the time of the inspection there were six service users accommodated. The Registered Manager said on the dementia unit only staff that were trained in dementia care were allowed to be on duty. The Registered Provider must detail proposals for staffing when the home is not fully occupied in the form of a staffing plan. On the general nursing unit there were two Registered Nurses and five carers on duty. It was also discussed with the Registered Manager that any changes to the staffing levels must be agreed with the CSCI in advance of any changes being made. There is one person who undertakes laundry duty. The hours of work are 2pm to 6pm for five days of the week. On the day of the inspection the laundry room was piled high with laundry, which required attention. It was made clear to the Registered Manager that care staff are not to be used for laundry duty Parkfield House G61-G10 s10935 Una Parkfield House v214439 120905 Stage 4.doc Version 1.40 Page 17 when they are rostered for care duties. The duty rosters viewed indicated that there were no staff rostered for laundry duty at the weekends. The rosters indicated that generally there are two domestic staff on duty. On occasions there is one member of staff on duty Two staff files were viewed at the inspection. One staff employment file viewed contained details of the applicants completed application form, medical declaration, 2 references, copy of passport and terms & conditions. A POVA First check had been carried out. Details of training undertaken were also available. The other file viewed contained all the required information with the exception of one reference. This was discussed with the Registered Manager. The interaction between staff and service users was observed. The staff appeared to be caring and respectful. Parkfield House G61-G10 s10935 Una Parkfield House v214439 120905 Stage 4.doc Version 1.40 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) 34,35 and 38 Service users’ money is well managed and therefore service users financial interests are safeguarded. Systems were in place for the effective and efficient running of the business. Shortfalls in staff receiving fire drill training, potentially place service users at risk. EVIDENCE: The business plan for the year 2005-2006 was available. This needed to be updated to include the dementia care unit. Profit and loss accounts were also available for the period end 31/3/04. The home deals with small amounts of money for some service users and records are kept of all receipts and expenditures. The home has a safe facility Parkfield House G61-G10 s10935 Una Parkfield House v214439 120905 Stage 4.doc Version 1.40 Page 19 and receipts are given for any items given in for safekeeping. Where possible the staff encourage the relatives/representatives of service users to deal with the service users finances. Servicing records were viewed at random and were up to date. Risk assessments had been updated by the Registered Manager to include the dementia unit. Fire drill records indicated that not all staff had received fire drill training, this also included night staff. Parkfield House G61-G10 s10935 Una Parkfield House v214439 120905 Stage 4.doc Version 1.40 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. 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 x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 x 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x 3 3 x x 2 Parkfield House G61-G10 s10935 Una Parkfield House v214439 120905 Stage 4.doc Version 1.40 Page 21 yes 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 17(1)(a) Schedules 3&4 Requirement 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.(Previous timescale of 23rd May 2005 not met) Where service users require input from another health care professional this must be acted upon. All bedrail assessments must be completed in full (Previous Timescale of 23rd May 2005 not met). All lapstrap assessments must be completed in full. Documentation in relation to the bereavement wishes of service users must be completed, where a service user or their representative does not want to discuss this, then this must also be recorded. The Registered Persons must ensure that additional laundry hours are provided to meet the laundry requirements of the service users. Staff records must contain the information as required by the Care Homes Regulations 2001(Previous timescale of 3rd Timescale for action 10/10/05 2. 7 17(1)(a) Schedule 3 13(4) 10/10/05 3. 8 10/10/05 4. 11 12(3) 10/10/05 5. 27 18 10/10/05 6. 29 19, Schedule 2 10/10/05 Parkfield House G61-G10 s10935 Una Parkfield House v214439 120905 Stage 4.doc Version 1.40 Page 22 June 2005 almost fully met) 7. 38 17(2) Schedule 4.14 23(4)(c)(e ) The Registered Persons must ensure that a log is maintained to demonstrate that all staff have received fire drills with the frequency specified under the Fire Precautions Act, 1971. All night staff must receive fire drill training. Records of this training must be maintained. 10/10/05 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 3 Good Practice Recommendations It is strongly recommended that the Registered Manager ensure that needs led assessments received by the home are up to date. Parkfield House G61-G10 s10935 Una Parkfield House v214439 120905 Stage 4.doc Version 1.40 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. 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