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Inspection on 25/05/05 for Carlisle Dementia Centre (Parkfield)

Also see our care home review for Carlisle Dementia Centre (Parkfield) for more information

This inspection was carried out on 25th May 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The acting manager has many years` experience and had worked at Parkfield in a supervisory role before being promoted to her current post. This meant that she understood what was required of each person in the team. During the last year this home has been through a period of instability due to changes in ownership and management. The new owners were determined that service users would not be adversely affected by the changeover and have provided a sound support structure to assist the new acting manager to develop the necessary confidence to fulfil her new role. Both staff and service users had the utmost respect for her and spoke warmly about her commitment and the way she competently managed the home.

What has improved since the last inspection?

What the care home could do better:

Some of the files relating to new members of staff had some essential pieces of information missing. A requirement has been made to cover this shortfall.

CARE HOMES FOR OLDER PEOPLE Parkfield 256 London Road Carlisle Cumbria CA1 2QQ Lead Inspector Jane Strawbridge Unannounced 25 May and 22 June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Parkfield F58 F10 s61178 parkfield v225823 250505 ui stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Parkfield Residential Home Address 256 London Road Carlisle Cumbria CA1 2QQ 01228 818933 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) Hometrust Care Limited Care Home 32 Category(ies) of OP - Old Age registration, with number DE(E) - Dementia, over 65 of places PD - Physical Disability Parkfield F58 F10 s61178 parkfield v225823 250505 ui stage 4.doc Version 1.30 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 by 31st July 2004.. 2. The staffing levels for the home must meet the Residential Forum Care Staffing Formula for Older Adults. 3. The outstanding requirement made by the Fire Service with regard to the exit from the rear staircase leading from the first floor to the ground floor must be attended to by 31st December 2004. Date of last inspection 27 January 2005 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 throughout the home and there are four communal bathrooms, which have equipment to assist people to get in and out of the bath safely and in comfort. There is a car park and garden with seating areas. Parkfield F58 F10 s61178 parkfield v225823 250505 ui stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two half days. It was necessary to do it this way because the inspector arrived on the first day to find that there had been an outbreak of vomiting and diarrhoea a few days previously and precautions were in place to prevent further cases. Therefore the inspector looked at case files and records on the first day and then on the second day, spent time looking round the home, speaking to service users, their visitors and staff. On the first stage of the inspection the home’s acting manager and the area manager were present. The acting manager was present during the second stage. What the service does well: What has improved since the last inspection? What they could do better: Some of the files relating to new members of staff had some essential pieces of information missing. A requirement has been made to cover this shortfall. Parkfield F58 F10 s61178 parkfield v225823 250505 ui stage 4.doc Version 1.30 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 F58 F10 s61178 parkfield v225823 250505 ui stage 4.doc Version 1.30 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 F58 F10 s61178 parkfield v225823 250505 ui stage 4.doc Version 1.30 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) 3, 5 The practice of the thorough assessment of potential service users ensures that the home can provide a service to meet all the needs of the residents. EVIDENCE: New service users were admitted to the home on the basis of an assessment of need. Prior to offering a place senior staff visited the potential service user at home or in hospital to confirm that the home could meet the identified needs and to offer them information about the home. The care plans were drawn up using the available information gathered at this pre - admission assessment The prospective service users and their relatives were encouraged to visit the home for the day or to move in for a trial period to see whether the home would be suitable. Some service users confirmed that this had been useful in helping them to make a decision. Parkfield F58 F10 s61178 parkfield v225823 250505 ui stage 4.doc Version 1.30 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 standard(s) 7, 8, 9, 10, 11 The health and care needs of service users are well met with evidence of multi disciplinary working taking place on a regular basis. EVIDENCE: Each service user had a care plan detailing their health and social care needs and how these needs would be met. However there were some omissions that need to be addressed; for example each care plan should show that the service user has been involved in drawing it up and that dates for reviews and evaluations have been included. The daily records were well written and showed that staff arranged for the appropriate health care professionals to attend to service users’ health care needs. Assistance was given to service users to attend out patient appointments at local hospitals and clinics and they were able to consult with their doctors in private if they wished. Service users said that the staff treated them with respect and courtesy and they always knocked on their bedroom doors before entering. During the inspection this was seen to be the case. Steps had been taken to implement the requirements that had been made by the pharmacist inspector and the home’s staff had been given training in the administration of medication. Parkfield F58 F10 s61178 parkfield v225823 250505 ui stage 4.doc Version 1.30 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 Service users’ wellbeing is encouraged and promoted by continued social contact with families and friends who visit the home. The meals in this home offer a varied range of food that meets the service users tastes and choices. EVIDENCE: The home had an “open door” policy regarding their visitors who were welcome at reasonable times of the day. Service users said that their visitors were always made to feel welcome by the staff on duty when they visited. Some visitors saw their relative and friends in the communal rooms and others in the privacy of the bedrooms. Several service users commented that in recent months they had not been able to participate in social activities in the local community as much as they wished. They also made comments about how they spent their time during the day. Some service users said they had also commented about not being able to use the garden on fine days or go out as often as they had been used to doing. These matters had been raised at the meeting at the end of May. However they said they were unaware of what progress was being made to address their concerns. These concerns were discussed with the acting manager who said that that she was aware of these comments and an activities organiser had recently been Parkfield F58 F10 s61178 parkfield v225823 250505 ui stage 4.doc Version 1.30 Page 11 appointed so that the service users should soon notice an increase in opportunities to take up interesting and meaningful activities. She also said that a new gardener was now in post and was currently working to make the garden a facility for people to enjoy. The home’s car was available for outings and would be in use in the near future. This will be monitored at the next inspection. A good practice recommendation has been made to address the shortfall in communication. The meals in the home are served either in the dining room or in service users’ own rooms. Three full meals a day were served, always with a choice of menu, with drinks and snacks in between. Care staff provided assistance to service users at meal times as required. Service users said they enjoyed their meals and there was always a further choice if there was something on the menu that they did not want. Parkfield F58 F10 s61178 parkfield v225823 250505 ui stage 4.doc Version 1.30 Page 12 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 a satisfactory complaints procedure. Staff members have a sound knowledge and understanding of the home’s policies and procedures that protect service users from risk of harm or abuse. EVIDENCE: All service users had been given a copy of the home’s complaints procedure on admission to the home. There also were copies displayed in the entrance hall. Service users said that they knew who to speak to if they were unhappy about something and others said that they would ask someone else to speak on their behalf if necessary. Staff had been given training on the protection of vulnerable adults and how to recognise abuse. The home has a whistle blowing policy and the staff had been given training on how to use it. Parkfield F58 F10 s61178 parkfield v225823 250505 ui stage 4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 23, 24, 25, 26 This home has benefited from recent investment to improve some areas to create a more homely and attractive environment for those who live and work there. EVIDENCE: The inspector was shown around the home which was clean and tidy, providing a homely yet hygienic environment for the benefit of service users, staff and visitors. Staff members had been given training in food hygiene and infection control and protective clothing and gloves were available for use at appropriate times. They had worked effectively under difficult conditions to localise and control the recent viral infection that had affected service users and staff. Some communal rooms had already benefited from the maintenance and refurbishment programmes and had been recently decorated and carpeted to provide an attractive and homely environment. There are plans in place to refurbish all the communal areas including corridors and staircases. The private bedrooms were nicely decorated and had been personalised by their Parkfield F58 F10 s61178 parkfield v225823 250505 ui stage 4.doc Version 1.30 Page 14 occupants with their own pieces of furniture, ornaments and other treasured possessions. Each bedroom had an en-suite wash hand-basin and toilet. There were bathrooms nearby that had equipment to assist with bathing. Ramps and handrails provided safe access to the outside areas and fences around the rear garden ensured that it was secure space for service users to use. Work was ongoing to improve it for the enjoyment of service users. Parkfield F58 F10 s61178 parkfield v225823 250505 ui stage 4.doc Version 1.30 Page 15 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, 29, 30 Competent members of staff who have a good understanding of the service users’ support needs had been appointed to care for service users and positive relationships have developed between them. EVIDENCE: On the days of the inspection there were sufficient members of staff on duty to meet the needs of the service users. The recently appointed acting manager was in charge of the home and she was available to offer advice and support when needed. The inspector looked at some staff files and saw that some essential items of information were missing that would ensure that service users were protected from harm. A requirement has been made to address this shortfall. All care staff had been given mandatory induction and foundation training following their appointment. The home offers a range of training opportunities for all staff and training records are kept. All care staff had been offered the opportunity to complete an NVQ in care. Ten members of the care staff team had completed training in medicine administration and all members of staff had received training on basic food hygiene and infection control. Parkfield F58 F10 s61178 parkfield v225823 250505 ui stage 4.doc Version 1.30 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36, 37, 38, The acting manager is supported by the senior staff in providing clear leadership with all staff demonstrating an understanding of their roles and responsibilities. EVIDENCE: The acting manager was being supported in her new role by regular visits from the area manager and registered owner and by the small team of senior staff. Her previous experience as a senior carer in the home meant she knew the capabilities of the staff group. Formal staff supervision was taking place regularly and a newly developed system was being used to record each session. The inspector spoke to members of staff who said “the manager was settling into her new role after the change over” they felt supported and there were “training opportunities for everybody.” There are plans for the acting manager to enrol on the Registered Managers Award later this year and she has almost completed the NVQ Level 4 in care. Parkfield F58 F10 s61178 parkfield v225823 250505 ui stage 4.doc Version 1.30 Page 17 The home’s health and safety records were complete and showed the home’s staff group are committed about ensuring the health and safety and wellbeing of the service users, themselves and colleagues. The fire log was up to date and training for staff had been completed within the required time limits. Parkfield F58 F10 s61178 parkfield v225823 250505 ui stage 4.doc Version 1.30 Page 18 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 x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 3 3 x x 3 3 3 Parkfield F58 F10 s61178 parkfield v225823 250505 ui stage 4.doc Version 1.30 Page 19 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP29 Regulation 19,(4) Requirement The acting manager must ensure that all staff files contain the information and documents listed in Schedule 2 The acting manager must submit her application for registration to the Commission for Social Care Inspection as stated in the Conditions of Registration. Timescale for action 31 July 2005 31 July 2005 2. OP31 8 3. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP12 OP31 Good Practice Recommendations The acting manager should ensure that service users are kept informed about the outcome of their suggestions to improve the quality of the services provided by the home. The acting manager should complete NVQ level 4 in care and begin the Registered Managers Award as a matter of urgency. Parkfield F58 F10 s61178 parkfield v225823 250505 ui stage 4.doc Version 1.30 Page 20 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 F58 F10 s61178 parkfield v225823 250505 ui stage 4.doc Version 1.30 Page 21 - 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!