Inspection on 11/05/06 for Carlisle Dementia Centre (Parkfield)

This inspection was carried out on 11th May 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

Carlisle Dementia Centre... 18/08/09

Carlisle Dementia Centre... 09/07/08

Carlisle Dementia Centre... 18/09/07

Carlisle Dementia Centre... 27/01/06

Carlisle Dementia Centre... 25/05/05

Carlisle Dementia Centre... 27/01/05

Carlisle Dementia Centre... 06/09/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Parkfield Residential Home 256 London Road Carlisle Cumbria CA1 2QQ Lead Inspector D Jinks Unannounced Inspection 11th May 2006 10:30 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 Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 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 Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Parkfield Residential Home Address 256 London Road Carlisle Cumbria CA1 2QQ 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) 01228 818933 Hometrust Care Limited Vacant Care Home 32 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (15), of places Physical disability (2) Parkfield Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. A full time manager who is suitably qualified and experienced should be in post and registered with the Commission for Social Care Inspection. The staffing levels for the home must meet the Residential Forum Care Staffing Formula for Older Adults. 2. Date of last inspection 27th January 2006 Brief Description of the Service: Parkfield provides care and accommodation for up to 32 older people, 15 of whom may also have dementia, and two of whom may have a physical disability. The home is a three storey detached property quite close to the centre of Carlisle. The accommodation for service users is provided on the ground and first floors. There is a passenger lift, handrails, grab rails, and ramps to assist people in moving around the home. All of the bedrooms are for single occupancy and have en-suite toilet and washbasin facilities. There are Additional toilets and communal bathrooms, which have equipment to assist people to get in and out of the bath safely and in comfort. The home has a pleasant garden with seating areas and car parking facilities. The manager has produced an information booklet about the services the home can provide and a copy of the latest inspection report is available at the home. Both these documents are available from the manager on request. Parkfield Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of this service included a visit to the home and meeting with the manager and staff working at the home. The views of some of the people living in the home were obtained through discussions and the completion of questionnaires. Comments from relatives and district nurses were also received via questionnaires and telephone calls. The manager of the home was asked to complete a detailed questionnaire about the home and the services that it can provide, but this was not returned. What the service does well: What has improved since the last inspection? What they could do better: The manager has not completed the registration process with the Commission for Social Care Inspection within the specified time limits and there is a requirement for this shortfall to be addressed. There are also some shortfalls in training for staff. The manager must make sure that staff are given training to help them understand adult protection, the needs of people with dementia and other special training where necessary. Parkfield Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 Page 6 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 Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 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 Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 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): 3 (Standard 6 is not applicable) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users only move into the home when their needs have been assessed to ensure that the home can meet their requirements. EVIDENCE: Detailed care needs assessments are carried out and a record is kept on the service user file. The social service department and the hospitals also provide assessment details. The assessments help to ensure that the needs and wishes of service users are met appropriately. Service users are able to visit the home prior to admission and a trial period of four weeks is offered prior to permanent placement or residency. The care needs of the people already living at the home are taken into consideration when assessing potential residents for admission. Parkfield Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 Page 9 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 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users health and personal care needs are clearly set out in an individual care plan, which is kept under regular review. This helps to ensure that people using this service receive appropriate support and assistance. EVIDENCE: The people living at the home have a detailed plan of their care needs, which include risk assessments and safe systems of work for staff to follow. The plans are reviewed each month. People susceptible to falls or pressure sores have suitable assessments in place. People living at the home have access to GPs, District Nurses, Chiropodists, Occupational Therapists and social workers. A record of general health care information is kept on the service user records. The home has suitable medication policies and procedures in place. Service users medication is supplied in monitored dosage systems. Senior staff have received formal medication training. Other staff have received in-house training and have been supervised on six occasions and assessed as competent to carry out the administration of medication. Medication records are completed as the medication is administered to each individual. These records Parkfield Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 Page 10 contained a photograph of the service user to assist with correct identification of the person. Service users requiring insulin injections are supervised by the District Nurses. There were no service users self-administering their medication at the time of the inspection. The manager has ensured that secure storage facilities are available for residents assessed as able to or wishing to manage their own medicines. Medication requiring cold storage is kept in the domestic fridge. This medication is stored separately from foodstuffs and in a locked box. The way in which the home records matters affecting the daily lives and care of service users could be improved. This will help to ensure that any significant events in the service user’s life are not overlooked. The people living at the home were complimentary of the staff. They felt that staff respect them as individuals and are mindful of their privacy and dignity when assisting with personal care tasks. Staff were observed working with the people living at the home and were seen to be encouraging their independence wherever possible. The district nurse was contacted as part of the inspection process. She confirmed that the home contact her for support and advice when necessary. She related to a service user who was coming to the end of her life, she said that the staff had looked after this person ‘beautifully’ during this period. Parkfield Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 Page 11 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. Service users are able to exercise choice and control over their lives. The manager encourages service users to air their views and participate in the daily life of the home. EVIDENCE: Stimulating activities are offered to people living at the home and they can choose whether or not to participate. An activities co-ordinator has been appointed by the home and a room has been made available for activities. There are a stock of puzzles, games, crafts, TV and videos. During the visit the activities co-ordinator was seen taking two service users out to a local garden centre. Photographs and newsletters on the residents notice boards describe events and parties that have recently taken place. Activity questionnaires have been issued to people living at the home and the ones that have been returned are being looked at in order to further develop the activities programme. Residents meetings are held regularly at the home and are open to relatives and staff at the home. The manager at the home had organised these meetings. The minutes were produced as a newsletter and there was evidence to show that service users views and wishes had been acted upon. The manager was in the process of trying to organise a summer holiday for the residents at the home. Parkfield Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 Page 12 There is a monthly holy communion service held at the home and arrangements can be made for service users to be taken to other religious services within the city of Carlisle. The activities co-ordinator had also helped some of the ladies at the home with manicures and painted nails. A hairdresser visits the home each week and caters for both the male and female residents at the home. Staff induction training includes an awareness of the value of social activities for people living at the home. People living at the home can receive their visitors in one of the lounges or in their own room. Visits made after 8pm at night take place by prior arrangement. This had been discussed and agreed at a residents meeting and had been introduced as a safety measure. People living at the home said that the meals were very good and there was a varied choice of food on the menu. The menus were looked at during the visit and the chef was spoken to briefly. Menus confirmed that there was a wide variety of food available and included fruit and vegetables. If service users wanted something different that wasnt on the menu then this could be accomodated. Discussions with staff and direct observations indicate that service users have regular meals, snacks and drinks. Drinks were available at any time and if service users were hungry staff could also access the kitchen at any time. Parkfield Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 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 the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are confident that their comments are listened to and acted upon by the manager and staff have training which, provides service users with some protection. EVIDENCE: Service users, staff and visitors to the home have access to the home’s complaint process. A summary of it is included in the documentation and information produced about the home and a copy is displayed on the notice board in the home. Service users said that they were able to talk to the manager if they were not happy about something or had a comment to make. They were confident that the manager would listen to them and deal with their concerns. The residents meetings also provide an opportunity to discuss general issues. The staff employed at the home have received some adult protection training and there is a policy and procedure available at the home. The staff spoken to during the visit said that if they thought that a service user was being abused they would be able to tell the manager. Parkfield Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 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 the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a wellmaintained environment, which provides aids and equipment to meet the care needs of the people living at the home. EVIDENCE: The home employs two domestic staff and a handyman whose main duties relate to the cleanliness and maintainence of the home. The home does not have a formal programme for renewal and decoration of the premises. The manager has authorisation from the company to purchase whatever is required and if rooms need redecorating or furnishing he is able to deal with this too. The handyman at the home is very organised and ensures that all the necessary checks are carried out at the appropriate time and detailed records are kept. The checks include fire alarms, emergency lighting, water temperatures, central heating systems, passenger lift maintenance and the maintenance of bed rails, wheel chairs and moving and handling equipment. The home is maintained to a high standard throughout. Discussions with some of the people living at the home indicated that they are due to have their Parkfield Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 Page 15 rooms re-decorated. Their involvement with the choice of paint and colour scheme was very evident. The manager said that the fire officer had visited the home. Any outstanding work and requirements have been carried out and complied with to the fire officer’s satisfaction. The accommodation at the home is spread over two floors. There are communal lounge areas, dining areas, toilets and bathrooms on both floors. Every room at the home has en-suite facilities. There is an enclosed garden area where service users may sit out in good weather. A staff room is located in the basement, opposite the activities room. The corridor around this area smelled strongly of cigarette smoke and this was pointed out to the manager. Parkfield Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 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 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 adequate. This judgement has been made using available evidence including a visit to this service. The skill mix of staff employed at the home generally meets service users needs. EVIDENCE: People living at the home are generally satisfied with the care they receive at the home. They said that staff are usually available to provide the care and support that they need. Staff rotas indicated that sufficient staff were on duty at all times in order to meet the needs of the people using this service. Agency staff are not used at the home. This helps to ensure that people living at the home are cared for in a consistant manner and by people they know well. Separate staff are employed by the home to attend to the kitchen and domestic duties. Four staff recruitment files were looked at during the inspection visit. Three of them contained application forms and one person had submitted a CV instead. Where staff have been employed from abroad, letters of recommendations and criminal record checks have been obtained. The letters and official documents had been translated into English by an approved translator. Photographs of the staff are included in their personal files and their identity has been checked and verified. Where names had been changed through marriage, for example, this had also been verified. In general, written references and Enhanced Criminal Record Bureau (CRB) checks had been obtained. Staff were spoken to during the visit. They described some of the training that they have undertaken whilst working at the home. Staff at the home do have Parkfield Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 Page 17 access to training but some gaps were identified. The home does not have a training and development plan to help identify and plan for addressing these shortfalls. One member of staff thought that further training in dementia would be very helpful in order to better understand the needs of people suffering from this condition. Staff commented on the atmosphere at the home - it was friendly and calm. This was observed during the inspection visit. Staff said that they were supervised in their work about every three months and that the manager was trying to set up regular individual meetings with staff. Supervision records confirmed this. The staff also commented positively on the organisation at the home since the appointment of the new manager. The manager was said to be very approachable and the discussions with staff indicated a sense of loyalty towards him in a positive way. The staff felt that the service users were well looked after and catered for. The food was good and if people wanted more drinks or food then the staff ensure that it is obtained. Where service users may not think to ask for food or drinks, staff were seen to be asking them and encouraging them. Parkfield Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 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 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, & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager demonstrates strong leadership skills, which helps to ensure that service users are living in a home, which is generally run in their best interests. EVIDENCE: The people living at the home are generally satisfied with the care that they receive. Several people commented on the improvements at the home since the new manager had been in post. One service user described him as a breath of fresh air. They said that the staff new their needs well and appeared calm and confident in their approach to their work. The home had an air of calmness and friendly atmosphere. Observations made during the inspection indicate that the home usually runs smoothly and in the best interests of the people living there. The manager is a registered nurse and has previous experience of managing care services. He does not have a recognised management qualification nor Parkfield Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 Page 19 has he applied for registration with the Commission for Social Care Inspection. This was discussed with him and he was advised to deal with this matter urgently. The manager has set up residents meetings and staff meetings and these take place on a regular basis. Newsletters are produced for service users and their relatives following the meetings and service users views and wishes are listened to and responded to appropriately. There are policies and procedures in place at the home in relation to health and safety and safe working practices. Fire drills and other safety checks are carried out and recorded as required. Records in relation to the servicing and maintenance of machinery, water temperatures, fire alarm systems, electrical systems and water temperatures are also kept at the home. Parkfield Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X X X X 3 Parkfield Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 Page 21 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 OP31 Regulation 8 Requirement The manager must submit his application for registration to the Commission for Social Care Inspection as stated in the Conditions of Registration. Previous timescale of 31/03/06 not met. The registered person must ensure that accurate records, kept of significant events in relation to the daily life and care of the service user. Timescale for action 30/06/06 2 OP8 17 1(a) 30/06/06 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 Refer to Standard OP30 Good Practice Recommendations A training and development plan for the home should be drawn up to detail plans to meet the required levels for this standard Parkfield Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Residential Home DS0000061178.V291710.R02.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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