Inspection on 16/08/07 for Parkfield House

This inspection was carried out on 16th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 06/10/09

Parkfield House 22/08/06

Parkfield House 07/10/05

Parkfield House 23/09/04

Parkfield House 07/05/04

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Parkfield House Thwaites Brow Road Keighley West Yorkshire BD21 4SW Lead Inspector Mary Bentley Key Unannounced Inspection 16 August 2007 09:30 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 Parkfield House DS0000019885.V344150.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. Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parkfield House Address Thwaites Brow Road Keighley West Yorkshire BD21 4SW 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) 01535 609195 01535 609195 Mr Michael John Flynn Mrs Pauline Hodge Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd August 2006 Brief Description of the Service: Parkfield House is in Keighley and access to the home is via a steep cobbled road. There are tiered gardens and a patio area overlooking the gardens. Parking is on the road outside the home and there is a bus stop nearby. The home provides nursing care for people aged over 65 years. The accommodation is on two floors with a passenger lift linking the two. There are seventeen bedrooms comprising of eight doubles and nine singles. Two bedrooms have en suite facilities. There are two communal lounges leading into one another, as well as a large conservatory that is used as both a lounge and dining area. In August 2007 the weekly fee was £495.00. The home told us there are no extra charges. Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. I did this unannounced inspection in one day and spent approximately 7.5 hours in the home. The purpose of this visit was to assess how the home is meeting the needs of the people who live there. During the visit I spoke to people living in the home, staff and management. I observed staff caring for people in the communal rooms; I looked at various records relating to care, staff, and maintenance and looked at some parts of the building. Before the visit we sent a number of comment cards to people living in the home, relatives and health care professionals who visit the home. Comment cards give people the opportunity to share their views of the service with us. The information we get is shared with the home without identifying who has provided it. In total 13 cards were returned. Before the visit the home provided us with a completed quality assurance selfassessment form. We have used some of that information as well as the information from the comment cards in this report. What the service does well: What has improved since the last inspection? The home continues to provide a good standard of care. Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 Page 6 The contracts have been changed and people are now given full details of the fees. Some improvements have been made to the range of social activities but there is still more work to do in this area to make sure that people have opportunities to spend their time meaningfully. 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. The summary of this inspection report can be made available in other formats on request. Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 & 3. Standard 6 does not apply to this service. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are given information about the service and every effort is made to make sure that the home will be able to meet their needs before they move in. EVIDENCE: “We chose Parkfield because we were pleased with the cleanliness, atmosphere and the obvious care given to residents.” Most people said they had been given enough information about the home before moving in. Some people were unable to visit before moving in, their families had chosen the home on their behalf, and they said they felt it was a good choice. Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 Page 9 The manager is very clear about the admission criteria and people’s needs are assessed before they are offered a place. Most people said they had contracts and copies of contracts were seen in the records. The contracts have been changed so that they show details of the full fee and the breakdown (how much will be paid by Social Services and/or the NHS and how much the person receiving care will pay). The manager said it is not always possible to confirm the details of the fee breakdown at the time of admission because the Social Services financial assessment had not always been done. Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s personal and health care needs are met in a way that respects their privacy and dignity. Some more work needs to be done on the care records so that the home can demonstrate care is being given consistently and in accordance with people’s preferences. EVIDENCE: These are some of the comments made by relatives of people living in the home: • “I’ve always been satisfied at the level of care given to my father. The staff are always willing and helpful towards him.” • “Yes I am informed when the doctor is called or if there are signs of deterioration in her health or well being.” • “She seems to be very well looked after” Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 Page 11 I looked at the care records of three people living in the home. The care plans are based on detailed assessments of people’s needs and set out how personal and health care needs will be met. The care plans contain some good detailed information about how people prefer to be cared for and show that people are encouraged to do what they can for themselves. The care plans are reviewed every month by nursing staff. There is not much evidence that people living in the home or their representatives are formally involved in reviewing care plans. The appropriate risk assessments are in place for example for the risk of developing pressure sores of the risk of falling. The wound care plans give clear information on the condition of the wound and the prescribed treatment. There was evidence that the tissue viability nurse specialist is consulted about the management of wounds. Nutritional risk assessments are done and weights are recorded every month. Action is taken to address any concerns about nutrition. The records show that people have access to a range of NHS services. Visits by GPs and other health and social care professionals are recorded. The daily records tend to focus on physical care needs and do not give a lot of information about how people have actually spent their time. The systems for managing medicines are satisfactory. The records showed that people’s medication is reviewed regularly. The care plans include information on people’s wishes with regard to end of life care. Most of the staff have attended palliative care training and the manager is looking at implementing the Liverpool care pathway. This is a model of good practice for palliative care. During the day I saw that staff were kind and respectful in the way they interacted with people. One visitor to the home said, “I have never noticed any discrimination at all. All residents are treated with care and respect equally”. Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home has a relaxed and informal atmosphere that promotes flexibility in daily routines and encourages people to exercise choice and control over their lives. The home is working towards improving the way social care needs are met to make sure that people can continue to experience a varied and interesting lifestyle. EVIDENCE: The home has a friendly and informal atmosphere and people were clearly comfortable in the environment and with staff. One person said “this is my home now”. Staff know people well, they know their preferences and daily routines are flexible to take account of these preferences. People said they can get up and go to bed when they want, some people said they like to go to their rooms Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 Page 13 early and watch TV for a while before they settle down for the night. People are encouraged to socialise but if they do not want to this is respected. The home said they respect and accept people as individuals and this was evident during the day. People said they could have visitors at any time. The home respects people’s wishes with regard to whom they want to see and where they want to see their visitors. Some people go out with family and friends. There are some organised activities; a singer visits the home about once a month and quizzes are held regularly. One person said, ”They are aware that entertainment and stimulation activities could be improved”. The manager agreed with this. People said the food was good. One person said she was a fussy eater but the cook knew what she would and would not eat and made sure she had food she liked. Although the menus are on the tables the meal served during my visit was not that meal on the menu, the manager said this was because the regular cook was on holiday. During the morning some people asked what was for lunch but staff were unable to tell them. Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People can be confident that any concerns they have will be listened to, taken seriously, and acted on. There are systems in place to make sure that people are protected from abuse. EVIDENCE: One person said “We have never needed to [complain], but know that if we have any concerns we are able to discuss them with senior staff.” Another person said they were not aware of the complaints procedure but “I would ring or write to the home if I had a complaint”. People said the home always responded appropriately to any concerns. Most people living in the home said they know who to talk to if they have any concerns. They said staff listen to them and take notice of what they say. The home has not had any complaints in the past 12 months and none have been referred to us. Senior staff work hard to promote and open culture and encourage people to talk about any concerns no matter how trivial they may seem. This means that people don’t often feel the need to use the complaints procedure. Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 Page 15 The required adult protection procedures are in place. The majority of staff have attended adult protection training, the manager said this is due to be updated. Information provided by the home showed that they have used advocacy services when necessary. Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 Page 16 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, 24, 25 & 26 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Parkfield House provides a clean, comfortable, and homely place for people to live. The choice of rooms available to people who are not independently mobile is somewhat restricted by the design of the building. EVIDENCE: The home was clean and tidy and there were no unpleasant odours. Generally the décor is satisfactory and there is an ongoing programme of decoration. Some people have personal belongings such as items of furniture, photographs, or ornaments in their bedrooms. People can have keys to their rooms if they want them. The communal rooms on the ground floor are suitably furnished and there are pictures, ornaments, photographs, and a drinks trolley that help to create a homely environment. There are good views from the conservatory and there is Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 Page 17 a patio where people can sit outside, weather permitting. People said they had not been able to get out much this summer but had been able to have lunch outside a couple of weeks ago. There is a lift to the first floor and most rooms have level access. There is one room that can only be reached by going up 2 steps and this is only offered to people who are able to walk up the steps. The corridors are fairly narrow meaning that it is not always easy to manoeuvre wheelchairs and hoists. On the advice of the fire officer and following consultation with the people involved a number of people with limited mobility have moved to the ground floor. This means that the choice of rooms available to new people moving in will be somewhat restricted. The temperature in the home was comfortable on the day of the visit. The manager said the problems with the hot water discussed at the last inspection had been dealt with. She said the hot water is sometimes slow to come through but is always available. The home has been given a 3 star rating (the maximum is 5) by Environmental Health for its standards of food safety and hygiene. Hand washing facilities are provided throughout the home. The laundry is suitably equipped to meet people’s needs. However, the floor surface is damaged and is in its present condition would be difficult to clean thoroughly creating a possible infection risk. Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 Page 18 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 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. There are usually enough staff to make sure that people get the care and support they need. The staff are trained and competent to care for people properly. People are protected by good recruitment procedures. EVIDENCE: People said the staff were kind and one person said, “The staff I have met seem very capable especially matron and assistant matron.” Another person said the skills of the care staff varied but they felt there was always someone on duty with the skills and experience to make sure that people’s health and social care needs were met. There is always at least one nurse on duty and usually there are 3 care staff on the morning shift and 2 care staff on the evening shift. There are two staff overnight. The manager and deputy manager work a lot of hours covering for both nursing staff and care staff. Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 Page 19 Over 50 of care staff have an NVQ (National Vocational Qualification) at level 2 or above. There are individual training records for each member of staff, these showed that staff are up to date with fire safety training and moving and handling. The manager is planning to arrange training to update staff on adult protection and infection control. The home has its own induction programme and is planning to introduce the nationally recognised Skills for Care induction standards. The home has a low staff turnover; one person has been recruited since the last inspection. The file showed that all the required checks had been completed before they started work. Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 Page 20 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, 33, 35 & 38 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The management team works hard to make sure that people are supported in making decisions and exercising choice. They encourage people to share their views and respond positively to ideas/suggestions for improving the service. EVIDENCE: The registered manager is a nurse; she has completed the Registered Managers Award and has several years relevant experience. Both she and the deputy manager have a very “hands on” approach to the management of the home. This is clearly appreciated by people living in the home and their relatives. One person said they have “Excellent contact with senior staff who discuss everything they feel we need to know.” Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 Page 21 Surveys are sent to people using the service approximately once a year. Any actions points that are identified are dealt with. The most recent surveys were done in May 2007, the results need to be summarised so that feedback can be given to people using the service. There are systems for internal auditing but these have lapsed, the manager is aware this is an area that needs attention. The home does not hold any personal money for people. The majority of maintenance records were available and were up to date. The gas safety certificate was overdue; this has now been dealt with. There were risk assessments in people’s individual files dealing with specific risks such as the use of bed rails. Risk assessments have been carried out for those people who are unable or unwilling to have footplates on their wheelchairs. Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 X X X 3 3 2 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 3 X 3 X 3 X X 3 Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 Page 23 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 OP12 Regulation 16(2) Requirement The programme of activities must be improved so that people have the opportunity to take part in a range of varied activities. Previous timescale of 31/10/06 not met. The laundry floor must be improved so that it can be cleaned properly to reduce the risk of cross infection. Timescale for action 14/12/07 2 OP26 13(3) 14/12/07 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 Refer to Standard OP2 OP18 Good Practice Recommendations When people cannot be given details of the fees at the time of admission they should be informed in writing of the reasons for the delay. Staff should attend training on the Mental Capacity Act. Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Parkfield House DS0000019885.V344150.R01.S.doc Version 5.2 Page 25 - 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!