Inspection on 22/08/06 for Parkfield House

This inspection was carried out on 22nd August 2006.

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 16/08/07

Parkfield House 07/10/05

Parkfield House 23/09/04

Parkfield House 07/05/04

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Hawkhills

Larchfield Manor

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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 Carol Haj-Najafi Key Unannounced Inspection 22nd August 2006 09:00 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.V297887.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.V297887.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 (25) of places Parkfield House DS0000019885.V297887.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th October 2005 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. A charge of £475 is made for one week’s stay. The pre inspection questionnaire states there are no extra charges. Parkfield House DS0000019885.V297887.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way in which care services are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group for example Choice of Home. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers outcomes to the people using the service. The judgements categories are “excellent”, “good”, “adequate” and “poor”. The judgements are recorded within the main body of this report. More detailed information about these changes is available on our website – www.csci.org.uk A pre-inspection questionnaire was completed by the home and this information has been used as part of the inspection process. Information from surveys which were sent to residents and health care professionals have also been included. Two inspectors carried out a site visit. Each inspector spent eight hours at the home. During the visit the inspectors looked around the home, and spoke to residents, staff, and one visitor. Records were looked at including; residents’ care plans, risk assessments, admission assessments, food records, staff recruitment and training records. What the service does well: What has improved since the last inspection? The care planning process has improved and there is more information about how residents’ needs should be met. Parkfield House DS0000019885.V297887.R01.S.doc Version 5.2 Page 6 More staff have achieved NVQ awards, which equips staff with knowledge and skills about good care practice. Qualified staff have attended training that increased their pressure care knowledge. 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. Parkfield House DS0000019885.V297887.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.V297887.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are appropriately assessed before they move into the home. However, they do not receive information about the terms and conditions of their stay before they move in. EVIDENCE: Records for the admission process for three residents were looked at. Someone from the home had carried out a pre admission assessment before they decided if the home could meet the needs of the residents. Key areas of need were assessed and the information was satisfactory. The manager had completed an admission information sheet with residents and relatives, and this outlined reasons for admission. Additional assessments that had been completed by health and social care professionals were also available. This practice is good because staff and management make sure they have sufficient information about each resident before they move into the home. Parkfield House DS0000019885.V297887.R01.S.doc Version 5.2 Page 9 One resident confirmed that someone from the home had visited them at the hospital and told them about Parkfield House. Four residents’ files were looked at. Three residents had a contract that outlined the terms and conditions of their stay at the home. Only one resident had not been issued with a contract. The cost of the placement is £475 per week and this should be included in the contract so the resident and their representatives are aware of the fees payable and by whom. Currently only the resident contribution is recorded, i.e. £102.97. Contracts are not issued until a few weeks after the resident has been admitted to the home, therefore they do not have details of the term and conditions that apply until after they have moved in. Details of room numbers are included on the contract. Intermediate care is not provided at Parkfield House. Parkfield House DS0000019885.V297887.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care planning process is good and individual needs are met. To further enhance the process, care staff and resident involvement should be developed. Effective systems are in place to make sure health care needs are met. Staff treat residents with respect and ensure their dignity and privacy is preserved. EVIDENCE: Four care plans were looked at. Each care plan identified how individual needs should be met. There was sufficient guidance for anyone reading the plans to understand how individual needs should be met. For example ‘able to wash upper body but may be reluctant, make sure everything is within reach, when in bed turn every three hours.’ Several residents wear incontinence pads. Care plans contained information about the type of continence aids that are required. One resident confirmed the contents of their care plan accurately reflected their needs. Qualified staff are responsible for writing the care plans and they review them monthly. Daily records were looked at. There were risk assessments and care plans for incidents that had occurred. For example, one resident had alleged that they Parkfield House DS0000019885.V297887.R01.S.doc Version 5.2 Page 11 had been treated unfairly. This was clearly documented, relatives and other professionals were involved and there was good information about how this should be managed. Care staff and residents do not currently have much involvement with the plans, it would be beneficial to look at how this could be developed to further improve the care planning process. All plans contained sufficient information about health care. Any involvement with healthcare professionals is documented, and there was evidence that concerns were followed up. Residents had been weighed monthly, and any concerns were recorded and appropriate action was identified, i.e. weigh weekly. There was evidence that when health care professionals had visited the home, relatives had also been invited to attend. One resident said she had received very good care during a recent period of ill health. We received comment cards from five health care professionals. All professional comment cards stated staff demonstrate a clear understanding of care needs, medication is managed appropriately and they are satisfied with the overall care provided. The home’s medication system is a Monitored Dosage System. An inspector observed administration of medication. This was administered appropriately and the staff explained to residents what they were doing. Medication records were looked at and they had been completed correctly. Medication storage was well organised. Staff were seen to treat residents with respect and preserve their privacy and dignity. Staff very discreetly talked to residents about personal care needs and kept informing them of what was happening. Staff spoke quietly and gave prompts where appropriate. Staff gave reassurance to one resident who repeatedly asked the same question. Staff were seen to sit and talk with the resident, others stopped and talked as they passed through the lounge. Parkfield House DS0000019885.V297887.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents feel well cared for and are stimulated by the staff team. Staff spend time with residents and this makes a big difference to their quality of life. The range of activities is limited and this is an area where further stimulation is needed. The meals are good and residents are happy with the food but it is not possible to monitor the nutritional quality because all meals are not recorded. The menus should be reviewed. EVIDENCE: The inspectors arrived at 9.00am and left the home at 5.00pm. Most of this time was spent in the communal areas, observing practice and talking to residents and staff. During this time there were many examples of very good staff interaction with residents. Residents were clearly very relaxed with staff, and obviously enjoyed their company. Staff were seen to spend time with the residents and had a good knowledge of their needs and their likes and dislikes. Staff were able to talk about what residents like to do, what they like to eat and their preferred routines. They also were able to talk to residents about family members and knew about their background. This demonstrates that staff treat residents as individuals and find out what is important to them. Parkfield House DS0000019885.V297887.R01.S.doc Version 5.2 Page 13 Inspectors spoke to many residents and they were all complimentary about the staff. Comments included ‘staff are very caring, staff are very good, staff always ask if you’re ok, staff are excellent, staff are very patient, they are very gentle, they respect older people, night staff are superb, the cook is brilliant’. A quiz was being held during the morning. Residents were clearly engaging in the activity and it was also generating discussions on various topics. Residents said they enjoyed the quizzes. Community singers also visit the home. We received comment cards from eight residents and five professionals. The comment cards were generally positive although varied responses were received in relation to activities, two stated activities were never arranged, two stated sometimes. The last inspection identified that in house and community activities were not satisfactory. Some residents said they would like more to do, and some staff said the level of activities could improve. Residents and staff were very complimentary about the quality of food. Residents comments included ‘the food is very good’, ‘I like the baking’. One resident said the cook talked to her when she arrived and wrote a list of all the foods she liked and disliked and she is given the portions she prefers. Several residents required assistance at lunchtime. Staff talked about the meal, took time to deliver each spoonful and told the resident what was on the spoon. This is good practice. A four-week menu was sent with the pre-inspection questionnaire but when this was looked at during the site visit, it was evident that the meals record did not correspond with the menus. Each Monday, eggs, chips and peas are served and Friday fish and chips, but the menus indicate different meals are served. The cook confirmed that the menus needed reviewing. Some residents have their meals liquidised, and on days when some foods are unsuitable to liquidise an alternative is provided. The alternative meal is not recorded. Parkfield House DS0000019885.V297887.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are happy at the home and feel they can talk to staff if they are unhappy. EVIDENCE: The complaints procedure was displayed near the entrance of the home. The procedure included contact details of the Commission. The pre inspection questionnaire stated that the home had not received any complaints within the last twelve months. It also confirmed that the home has an adult protection policy, which was last updated in January 2005, and staff have attended adult protection training. Comment cards from residents confirmed they know how to complain and who to speak to when they are unhappy. Residents said they can talk to staff and would tell them if they were not satisfied. Parkfield House DS0000019885.V297887.R01.S.doc Version 5.2 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 the following standard(s): 19, 20, 21, 22, 24, 25 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is pleasant and residents are comfortable in their surroundings. However, residents do not live in a well maintained environment because the hot water and heating system do not work properly. EVIDENCE: A full tour of the building was carried out. The inspectors looked around all communal areas and most bedrooms. The home was clean and tidy throughout and generally the home was odour free. Generally the décor was satisfactory. Many bedrooms were personalised and some residents had brought their own furniture with them. This is good practice and demonstrates that residents are encouraged to make their rooms homely. Residents were very comfortable and relaxed in their environment and were seen to wander freely around the home. Residents felt comfortable to choose what to watch on TV and turned it over as they wished. There were pictures, Parkfield House DS0000019885.V297887.R01.S.doc Version 5.2 Page 16 ornaments, photographs and a drinks trolley in communal areas which helped create the homely environment. Parts of the garden were overgrown and looked unsightly. The last inspection identified that the home should improve the gardens. It has again been recommended from this visit that this work should continue. It was a warm day when the inspection was carried out. All thermostats in the home were set at 0. However, several radiators were hot, which resulted in some rooms being too warm. Water temperatures were tested in bedrooms and bathrooms. The hot water tap did not work in some rooms, including the sluice room. The water was very hot in some rooms and only tepid in other rooms. Staff acknowledged there had been problems with the heating and hot water. They confirmed that they had to carry hot water in bowls because of the insufficient supply. This is not acceptable. The registered person is required to ensure that the heating is suitable for residents; that water temperatures are not excessively hot and that there is an adequate supply of hot water throughout the home. Most bedrooms had lockable facilities and a lamp, although some lamps were not near a socket. Some minor maintenance problems were identified during the tour, which included, no toilet roll holder, handles loose on chest of drawers, bathroom lock to en-suite not working (room 8), over sink light not working, door to vanity sink not closing properly (room 5), light bulb not working at top of laundry stairs, chest freezer lid broken, ceiling fan not working (dining room). Some bathrooms and bedrooms did not have adequate supplies of paper towels and toilet roll. Parkfield House DS0000019885.V297887.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The quality of staff on duty during the site visit was very good, which resulted in a high standard of care being provided. Recruitment practices and training programmes are satisfactory. EVIDENCE: As stated in previous sections of the report, the quality of staff working at Parkfield House has led to residents receiving a good standard of care. The staff that were on duty on the day of the inspection, demonstrated they were competent, skilled and caring. The home has a low turnover of staff and only two staff have been recently recruited. Their recruitment files were looked at. All the relevant information was available. Staff talked about completing various training courses, this included health and safety training and NVQ awards. 50 of care staff have NVQ level 2 or above. The pre inspection questionnaire also stated that staff have attended a range of training courses, including; Moving and handling, incontinence assessment, fire awareness, first aid, adult protection, infection control, positive dementia. Each staff has a file that contains training certificates. Two files were looked at. Parkfield House DS0000019885.V297887.R01.S.doc Version 5.2 Page 18 Both had a range of certificates and staff had completed at least one training course within the last six months. An individual training record is maintained but this was not looked at during this inspection. Parkfield House DS0000019885.V297887.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Satisfactory systems are in place to monitor the quality of care that is provided. The safety of residents and staff are protected. EVIDENCE: The registered manager is a qualified nurse and has completed the registered manager’s award, she was not present at the site visit. Resident meetings are held, although only one meeting has been held in 2006. Surveys are also sent to relatives. Several surveys had recently been returned but the manager had not had an opportunity to collate and analyse the information. A survey in 2005 identified some action points, and the manager had addressed these satisfactorily. Parkfield House DS0000019885.V297887.R01.S.doc Version 5.2 Page 20 The registered provider visits the home on a regular basis. Once a month he completes a Regulation 26 visit which looks at the conduct of the home. These reports were looked at during the inspection. A copy of these reports should be sent to CSCI. The pre inspection questionnaire stated that policies and procedures are available and regular maintenance and health and safety checks are completed at the home. The home does not hold any finances for any residents. Several wheelchairs were stored in the dining area. All footrests were removed. The deputy manager said when residents are in wheelchairs in the home footrests are removed for health and safety reasons but when they go out they have the footplates on. A written assessment must be carried out for each resident that uses a wheelchair in the home and if the assessment indicates footplates should be removed, the reason must be clearly recorded. Parkfield House DS0000019885.V297887.R01.S.doc Version 5.2 Page 21 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 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X 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 3 3 X 3 1 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 2 Parkfield House DS0000019885.V297887.R01.S.doc Version 5.2 Page 22 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 OP2 Regulation 5 Requirement The registered provider must ensure residents receive information about the accommodation to be provided and the fees payable, by not later than the day on which they become a resident. The registered person must provide a suitable range of activities to meet the needs of the residents. The registered person must ensure written records of meals are accurate. Menus should be reviewed. The registered person must complete the maintenance works identified in the report. The registered person must ensure the heating at the home is suitable for residents. The registered person must make sure there is an adequate supply of hot water at washbasins and baths. Parkfield House DS0000019885.V297887.R01.S.doc Version 5.2 Page 23 Timescale for action 31/10/06 2 OP12 16 31/10/06 3 OP15 16 31/10/06 4 OP19 23 30/11/06 5 OP25 23 31/10/06 6 7 OP25 OP26 13 23 The registered person must ensure water temperatures are not excessively hot. Suitable hand washing facilities must be provided in the sluice room. The registered provider must send a copy of the regulation 26 visit reports to the CSCI The registered person must assess the use of wheelchairs in the home. An individual assessment must be carried out for each resident that uses a wheelchair. 31/10/06 30/11/06 8 9 *RQN OP38 26 13 31/10/06 31/10/06 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 OP7 OP20 Good Practice Recommendations The registered provider should increase involvement of residents and staff in the care planning process. The registered person must continue to maintain and improve the gardens. Parkfield House DS0000019885.V297887.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 DS0000019885.V297887.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. 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