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Inspection on 09/07/08 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 9th July 2008.

CSCI found this care home to be providing an Adequate service.

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

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 home provides a friendly atmosphere and staff have a good relationships with the people that live there. People that live at the home and their families are encouraged to be involved in the progress of the home. There are opportunities at the home for people to attend residents` meetings with the management team at the home. This helps to ensure that their opinions are listened to and acted upon. Staff training has become a prominent feature at the home and almost all the staff at Parkfield have either already achieved or are working towards National Vocational Qualifications (NVQ). Basic care training and specialist training is also provided to staff. This helps to make sure that people living at Parkfield are supported and cared for safely and by competent staff. Some of the staff we spoke to said; `we get up to date training which allows us to provide the best possible care to the individuals we look after`. Some of the residents told us that `the staff are lovely and do the best they can` and a health care professional that visits the home said that `staff usually have right skills and respond appropriately to meet the needs of the residents`.

What has improved since the last inspection?

Improvements have been made to the general environment at the home and a new 8 bedroomed extension has recently been opened. Many areas have been redecorated and some furniture and carpets have been replaced. This has helped make the home a clean and comfortable environment for residents. Improvements to the social and leisure activities available at the home have been made and people have been consulted on their interests and hobbies. The manager has also made improvements to the way in which new staff are recruited, ensuring that all the proper checks have been made prior to them starting to work at the home. This helps to make sure that people using this service are protected from harm and are supported only by suitable staff.

CARE HOMES FOR OLDER PEOPLE Parkfield Residential Home 256 London Road Carlisle Cumbria CA1 2QQ Lead Inspector Diane Jinks Key Unannounced Inspection 9th July 2008 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 Residential Home DS0000061178.V361543.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 Residential Home DS0000061178.V361543.R01.S.doc Version 5.2 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 Mr Brian McCubbin Care Home 40 Category(ies) of Dementia (40), Physical disability (40), Old age, registration, with number not falling into any other category (40) of places Parkfield Residential Home DS0000061178.V361543.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: The registered person may provide the following category of service only: Care home only - Code PC To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Physical disability - Code PD The maximum number of people who can be accommodated is: 40 Date of last inspection 18th September 2007 Brief Description of the Service: Parkfield provides care and accommodation for up to 40 older people, some of who may also have dementia or 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, communal bathrooms and a shower room, which are equipped to assist people to access these facilities. There is a secure, sheltered garden area and car parking facilities at the home. A variety of information has been produced. This includes a brochure and service user guide. These documents are available on request from the manager. The scale of charges range from £363.00 to £449.00 per week (July 2008). Parkfield Residential Home DS0000061178.V361543.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The assessment of this service took place over several weeks and included a visit to the home. People using this service, staff, visitors and relatives were asked for their views and opinions about the home, either during the visit or by completing questionnaires. The manager completed an Annual Quality Assurance Assessment, which helped verify information throughout the inspection process. What the service does well: What has improved since the last inspection? Improvements have been made to the general environment at the home and a new 8 bedroomed extension has recently been opened. Many areas have been redecorated and some furniture and carpets have been replaced. This has helped make the home a clean and comfortable environment for residents. Improvements to the social and leisure activities available at the home have been made and people have been consulted on their interests and hobbies. The manager has also made improvements to the way in which new staff are recruited, ensuring that all the proper checks have been made prior to them starting to work at the home. This helps to make sure that people using this service are protected from harm and are supported only by suitable staff. Parkfield Residential Home DS0000061178.V361543.R01.S.doc Version 5.2 Page 6 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 Residential Home DS0000061178.V361543.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 Residential Home DS0000061178.V361543.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): Standards 1 and 3. Standard 6 does not apply to this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service generally have their health and social care needs assessed prior to moving into Parkfield. There are some gaps in the process, which may mean that people do not consistently have their needs and expectations met in the most appropriate way. EVIDENCE: Some of the people that use this service told us that they received enough information about the home to help them make a decision about going to live there. One of the people we spoke to during our visit to the home said ‘. My relative attended the home first of all for respite care. Before they came to live here the manager came to the house to assess their care needs and provided them with information about the home.’ The home has recently been extended and registered to offer services to more people. The provider has updated the information about the home to reflect these changes. The documents include information about trial visits, short Parkfield Residential Home DS0000061178.V361543.R01.S.doc Version 5.2 Page 9 stays, care planning and the assessment process. It is currently available in one written format, which may not meet the needs of some of the people that use this service. There are copies of the home’s statement of purpose, service user guide and brochure in each resident’s room. A sample of four care files was looked at. People moving into the home generally have their care needs assessed prior to moving in. One person had been admitted to the home in an emergency and did not have a care needs assessment. However, a review had been carried out at a later date by their social worker to help make sure that Parkfield was a suitable place for this person to live. Records show that assessments are usually obtained from social services or the hospital as appropriate. The home also carries out their own care needs assessments. Pre-admission assessments help the home to decide whether they are able to meet the needs and expectations of people wishing to move into the home. The documents we looked at do not always contain sufficient information. This means that people’s requirements may be overlooked, resulting in their needs and expectations not being met appropriately. Parkfield Residential Home DS0000061178.V361543.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): Standards 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. Care plans do not consistently provide sufficient details of people’s care needs or details of how those needs will be met. This means that people may not always receive the right level of care to meet their needs safely and effectively. EVIDENCE: At our last inspection of this service we asked the manager to make sure that people using this service had up to date and detailed plans of their care requirements and how these would be met. A senior member of staff audits the care files regularly and some improvements to the information recorded have been noted. However, important information is not consistently recorded, which means that people may not always have their needs met in the most appropriate way. Important information about nutritional needs and support is not always recorded in the care plan. Strategies for managing aggression or challenging behaviour are not consistently included in care planning. Some of the care plans we looked at do demonstrate that people are treated with respect. Individual choices and preferences are clearly recorded and Parkfield Residential Home DS0000061178.V361543.R01.S.doc Version 5.2 Page 11 people using this service are supported by staff to make decisions about their daily routines. Daily records show that people living at Parkfield have access to other healthcare professionals when needed. Records show that people living in the home are visited by doctors, community nurses, chiropodists, opticians and that they have access to dental treatment. The community mental health team are also involved with some of the people that live at this home, but the level of their involvement or the type of support they provide is not always included in the persons individual plan of care. Samples of medication records were looked at, together with the home’s arrangements for the safe keeping of medicines. Medicines were found to be stored safely during this visit. Cabinets and trolleys were clean, tidy and appeared well organised. The manager said that staff receive training in the administration of medication from an external provider and that the medication procedures have been re-enforced with staff during staff meetings and supervision meetings. Medication is supplied to the home via a monitored dosage system. These are colour coded to help ensure that medication is administered at the correct time each day. Where medicines are not supplied by this method, they are clearly labelled with individual’s name and instructions for administration. The sample of medication records we looked at are completed properly and are up to date. Where medication has been refused, this is clearly documented on the record. Where medication is regularly refused, records confirm that the doctor has been consulted and notified about this matter. Medications that have been prescribed for use ‘as and when required’ have been administered as prescribed by the doctor and not given routinely. Some information about this type of medication is referred to in individual care plans and daily notes. However, this is an area that could be improved upon to ensure that staff are provided with accurate and detailed information about the use of this type of medication. Parkfield Residential Home DS0000061178.V361543.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): Standards 12, 13, 14 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements have been made to help ensure that people using this service are provided with opportunities to participate in stimulating and interesting activities. EVIDENCE: At the last inspection of this service we asked the manager to consult with the people who use this service about their interests, hobbies and preferences. People have been asked about their interests and hobbies. The care files we looked at all contain documents called ‘Family Tree’. These have been completed with the help of people’s families. They provide information about their past lives, interests and hobbies. People living at the home are also given the opportunity to attend residents’ meetings to share their opinions and ideas. Satisfaction surveys have also been introduced to try to obtain the views of more people that live at the home. These things will help the manager to provide suitable opportunities for residents to have an improved lifestyle. The home now has two activities co-ordinators who organise interesting activities and outings. They have had the input of an occupational therapist to help ensure that activities are appropriate and presented to residents in a Parkfield Residential Home DS0000061178.V361543.R01.S.doc Version 5.2 Page 13 suitable manner. The occupational therapist continues to be involved at Parkfield in an advisory capacity. A monthly activities programme has been developed and is displayed on the notice board at the home. Consideration should be given to the way in which the programme is publicised, as the current format may not meet the communication needs of all the people that live at the home. Activities include arts and crafts, reading newspapers together and discussing issues, bingo, word games, films, day trips and there is to be a summer fete at the home soon. A newsletter is produced on a regular basis. This helps to keep people up to date with what is happening at the home, including details of the trips, activities and general life. Records of the activities people have taken part in are kept. Some of the people we spoke to during our visit told us that they had recently been for a day out to Silloth, which they enjoyed very much. Some of the ladies were having manicures and hand massages during our visit. People who participated in this inspection, either by completing a questionnaire or by direct contact were asked about their views on the food and meals available at the home. One member of staff felt that the menus and choice available could be improved upon. The views of people living at the home were variable. Some said that the food was very good and that they had plenty of choice, whilst others did not always like the food on offer and had ‘lost interest’. The service of the lunchtime meal was observed in one of the dining areas. The portions appeared to be of a reasonable amount and included fresh vegetables. One person needed assistance to get to the table and this was done sensitively and with good technique. However, an apron was placed upon them as a matter of course and without the staff member asking. The meals were placed on the table before the residents arrived in the dining room, although they did arrive shortly afterwards. One person had a pureed meal, served in a bowl and with the use of adapted cutlery – this helped them remain independent with eating. The member of staff serving the meal did not remind people what they had ordered. When we asked some of the residents what was for lunch they did not know. One lady sat to the table and said ‘what’s this? I’m not eating that, I don’t want it’. The meal was taken away without an explanation and no alternative was offered. Mugs of tea were brought in next and placed on the table the member of staff did not offer a choice of drink. Sauces are available in individual sachets, which is good for hygiene purposes. However, some of the people observed did not know what they were and were also unable to open them. The manager states that he is going to carry out food surveys over the next year, asking people about their likes, dislikes and suggestions for the menu. This will help to bring about an improvement to the food and menus on offer at the home. Parkfield Residential Home DS0000061178.V361543.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): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service are protected from harm and abuse. The manager follows good practices for reporting and responding to suspicions or allegations of abuse. EVIDENCE: There is a complaint process in place at the home. The people who participated in this inspection indicate that they are aware of the complaint process and know who to address their concerns to. Most of the people also said that staff listen and act on what they say, although some residents told us that this is not always the case. We told the manager about this matter. The home has developed a complaints recording system. This helps to ensure that complaints are dealt with appropriately. It also helps to inform the quality assurance and improvement programme for the home. The home has policies and procedures in relation to safeguarding vulnerable adults. Staff are provided with training in this subject as part of their induction training and on-going training. Some of the staff spoken to were asked about their understanding of adult abuse. They confirm that they have received training and are aware of the process for reporting and dealing with any suspicions that they may have. The home also has access to the local authority’s guidance on dealing with and reporting safeguarding matters. The home has reported two incidents to social workers over the last twelve months. The manager has also told us of any serious incidents that have Parkfield Residential Home DS0000061178.V361543.R01.S.doc Version 5.2 Page 15 occurred at the home and has demonstrated his commitment to ensuring that people who use this service are protected from harm and abuse. The staff recruitment process has also been reviewed to help ensure that staff do not commence working at the home until all of the necessary checks have been carried out. This helps to make sure that only suitable staff are employed as care workers. Parkfield Residential Home DS0000061178.V361543.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): Standards 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is maintained to a good standard. It provides a warm, comfortable and pleasant environment for the people that live there. EVIDENCE: An eight-bedroom extension has recently been added to the home. The new areas of the home have been decorated and furnished to a high standard and follow guidance from an occupational therapist to help ensure that it will meet the needs of residents. People who already live at the home have been given the option of moving to one of the new rooms if they wish and some of them have moved rooms. Most areas of the home are accessible to most of the people that live there. It is equipped with wheelchair ramps, handrails, and a lift to all floors. There are several communal lounge and dining areas on both floors of the home and people living at Parkfield can choose where they spend their time or eat their Parkfield Residential Home DS0000061178.V361543.R01.S.doc Version 5.2 Page 17 meals. The communal lounges are homely and comfortable. Some of the furnishings and carpets have been replaced. All bedrooms and communal areas have call systems installed. A separate smoking room is available for residents who wish to smoke. There are also communal bathrooms with assisted baths and toilet facillities near by. All the bedrooms at the home have en-suite toilet and wash basin facilities. The new extension has a shower room and a tracking hoist is in the process of being fitted to this room. This will give people who live in the home more choice about their personal care. Many of the existing bedrooms have been redecorated and recarpeted. People living at the home are encouraged to make choices about the colour schemes for their own rooms. Each room has a lockable space for the storage of valuables, money or medication. All rooms are nicely decorated and people living at the home are able to bring personal items such as photographs, ornaments, small items of furniture, TV’s, radio’s etc. Electrical items are subject to a safety test first. To the rear of the home, residents have access to a pleasant walled garden and are able to sit outside in good weather. The home employs a handyman to help ensure that the grounds and general maintenance of the home are kept to a good standard. The home also employs housekeepers to help ensure that the home is maintained in a clean and hygeinic condition. Care staff at the home are also responsible for some of the domestic tasks at times. The people who took part in the assessment of this service said that the home is always clean and fresh. Protective clothing such as gloves, aprons and dissolvable laundry bags are used in the laundry. Colour coded trolleys are also used to help ensure that clean and soiled laundry is kept separately. These measures help to reduce the risk of cross infection. Parkfield Residential Home DS0000061178.V361543.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): Standards 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service are supported by staff that are recruited safely and who receive appropriate training. EVIDENCE: We looked at the staffing rota during our visit to the home. It indicates that there are usually sufficient staff on duty at the home at all times. The home does employ housekeepers and cooks as well as care workers. Some of the care staff said that there are occasional circumstances when there are shortages in staffing levels. Some people thought that more domestic staff should be employed ‘as quite often carers have to do their job instead of spending more time with residents’. One person raised some concerns about staffing the new extension and the eight extra beds. They hoped that ‘our high standards of care will be maintained.’ Some of the people who live at Parkfield told us that most staff are ‘very good and very helpful.’ We observed that there was a very pleasant and friendly relationship between staff and residents. More than half the staff at the home have National Vocational Qualifications (NVQ) in Care, at various levels, including a large proportion of the night staff. The housekeeping staff are also working towards gaining NVQ. This will help ensure that safe working practices such as infection control procedures are adhered to, and that the home is clean and hygienic. Parkfield Residential Home DS0000061178.V361543.R01.S.doc Version 5.2 Page 19 We looked at the recruitment records of three members of staff that had recently been employed at the home. Employment application forms have been completed, together with a detailed history of any previous employment they may have had. References have been checked and the manager ensures that Criminal Record Bureau (CRB) checks and Protection of Vulnerable Adults (POVA) checks are undertaken. We also looked at the training records for five members of staff with varying roles at the home. Staff are provided with induction training and a variety of basic training courses such as manual handling, first aid, health and safety, fire safety, infection control and safeguarding adults. Other specialist training courses are provided, dependent on the role undertaken. For example the home’s maintenance person is also trained as the fire warden and has undertaken a variety of specialised health and safety courses. Care staff have attended training to help raise their awareness and understanding of dementia illnesses, equality and diversity, palliative care, challenging behaviour and the administration of medication. Training courses are provided by a variety of trainers, both in-house and from external training companies. Community nurses have also provided staff with some training in relation to skin care and two senior members of staff have undertaken a training course to help them assess residents with continence problems. Three senior members of staff are due to undertake a specialist, self-study, training course in dementia care, via Stirling University. The manager then plans to pass on the skills and knowledge learned, to all members of care staff at the home. This will help ensure that staff at the home are able to understand and meet the specialist needs of people with this type of condition. Parkfield Residential Home DS0000061178.V361543.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): Standards 31, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed by a competent and experienced manager. This helps to ensure that the home is run in the best interests of the people that live there. EVIDENCE: The new manager has completed the registration process with the Commission for Social Care Inspection. He is well qualified and experienced to manage this service. He ensured that we had all the information we requested as part of the inspection process. He provided comprehensive information about the service and acknowledged where improvements had been made and where further improvement could still be made. The manager has ensured that the majority of the requirements we made at the last inspection have been met and some of the good practice recommendations have been implemented. Some improvement to the care planning and risk assessment processes have Parkfield Residential Home DS0000061178.V361543.R01.S.doc Version 5.2 Page 21 been noted. There are some gaps, which may place people using this service at risk from harm or from receiving inappropriate care. Risk assessments are undertaken and records kept, although there are some gaps in this process e.g. safe systems of work, dealing with challenging behaviour, use of equipment (bed rails). Staff records show that they receive regular supervision and this is organised in a planned way. There are policies, procedures and records kept in relation to any money held on behalf of residents. Where possible residents are encouraged to take responsibility for this themselves and are provided with a safe place in which to keep their valuables. The manager usually ensures that we are kept informed of incidents that happen in the home and has responded appropriately to issues that could place people using this service at risk from harm or abuse. Some incidents have not been reported as required, particularly when the manager was on holiday. He needs to make sure that staff left in charge of the home are familiar with this process. There is an accident book at the home, some but not all of the incidents we became aware of during our visit were recorded. Some quality assurance work has started to take place and residents are being asked about their views on various matters within the home. Residents meetings continue to be held and this forum helps people to voice their opinions, ideas, suggestions or raise any concerns. The manager acknowledges that this is an area that can be improved upon. Detailed maintenance records are kept by the home to help ensure that equipment and appliances are maintained and kept in a safe condition. Parkfield Residential Home DS0000061178.V361543.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 3 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 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 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 2 Parkfield Residential Home DS0000061178.V361543.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 OP7 Regulation 15 Requirement A detailed plan of care must be developed for each person using this service; taking into account their individual needs and risk assessments. This will help ensure that people using this service are supported safely and the care needs and outcomes identified are being met properly. (Previous timescale 30/11/07 not met). The Commission for Social Care Inspection must be notified of any event, which adversely affects the well-being or safety of any person using this service. (Previous timescale of 01/11/07 not met). Risk assessments must be carried out for all aspects of working practices at the home. Risk assessments must record the risks and hazards and provide safe systems of work for staff to follow. This will help minimise the risk of harm or injury to both people using this service and staff employed at the home. (Previous timescale of 01/11/07 not met). DS0000061178.V361543.R01.S.doc Timescale for action 31/08/08 2. OP37 37 30/07/08 3. OP38 13 31/08/08 Parkfield Residential Home Version 5.2 Page 24 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 OP3 Good Practice Recommendations It is recommended that care needs assessments be reviewed so that they clearly identify the care and support needs and reflect the preferences and choices of people using this service. Care plans should contain more detailed information about the use of PRN medication, including the dosage, when it should be administered, the reasons for its’ administration and monitoring the effectiveness of its’ use. Mealtime activities should be reviewed to ensure that staff communicate with residents effectively. This will help ensure that people using this service are given choices and are treated with dignity. 2. OP9 3. OP15 Parkfield Residential Home DS0000061178.V361543.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North West Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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. 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