CARE HOMES FOR OLDER PEOPLE
Parkfield Rest Home 9 Parkfield Road Manningham Bradford West Yorkshire BD8 7AB Lead Inspector
Michael Smithson Key Unannounced Inspection 4th July 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Parkfield Rest Home DS0000001217.V298347.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 Rest Home DS0000001217.V298347.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Parkfield Rest Home Address 9 Parkfield Road Manningham Bradford West Yorkshire BD8 7AB 01274 488280 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) Mrs Letitia Alake Fehintola Mrs Letitia Alake Fehintola Care Home 9 Category(ies) of Past or present alcohol dependence (1), registration, with number Dementia - over 65 years of age (2), Mental of places disorder, excluding learning disability or dementia (1), Old age, not falling within any other category (5), Physical disability (1) Parkfield Rest Home DS0000001217.V298347.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The place for PD is for the named service user only. Date of last inspection 6th March 2006 Brief Description of the Service: Parkfield Rest Home is a large Victorian house in a residential area near Valley parade football ground in Bradford. The home is registered to provide personal care for up to nine older people. The accommodation consists of three single and three double bedrooms. There is a lounge and separate dining room. There are gardens to the front and a large paved area at the back of the home. Parkfield Rest Home DS0000001217.V298347.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. One inspector Mick Smithson undertook the inspection. It was unannounced and took place over the morning and early afternoon of the 4th July 2006. It was a key inspection for this year. Copies of reports for this and previous inspections are available on the CSCI website. The home is provided with a copy of the reports. The focus of the visit was to look at progress made since the last inspection, assess the key standards and to spend time with service users. A spot check of the service user and staff records was also undertaken. The inspector did spend time speaking to service users. Although 3 had gone out either shopping and to attend a doctors appointment. The service user used public transport accompanied by a member of staff. Three of the service users have all lived at the home for a number of years. One was a recent admission. They all have the opportunity to make choices in their daily lives. They enjoy going out shopping with the staff and by themselves. They also enjoy the annual holiday. What the service does well:
Parkfield is a small friendly home that provides a good basic service and meets the majority of the key standards. The home is able to meet the needs of the current service users. The staff team has remained stable, which helps to provide continuity of care. A good diverse mix of nationalities are employed among the staff team, which brings different cultural experiences into the home. The home is clean and provides a comfortable and homely environment. Service users are helped to lead as normal a life as possible and enjoy going out into the community independently. Staff and residents also go out together as a group using public transport for day trips which are planned often on the spur of the moment. Service users said that they enjoyed the meals and have a mixture of home cooked food, takeaways and meals out. Routines in the home are flexible and centred round the needs of the service users. The new admission to the home was admitted following a good pre-admission assessment, an introductory visit and was offered a trial stay. A review had
Parkfield Rest Home DS0000001217.V298347.R01.S.doc Version 5.2 Page 6 been organised to decide if the placement was suitable. The service user felt he benefited from a good admission process. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Parkfield Rest Home DS0000001217.V298347.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 Rest Home DS0000001217.V298347.R01.S.doc Version 5.2 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 and 5. Standard 6 is not applicable. The quality of the outcome in this area is good. This judgement was made using available evidence including a site visit. Service users are fully assessed prior to admission and are given the opportunity to decide if the placement is suitable. EVIDENCE: A copy of the combined statement of purpose has now been provided. The information is basic but does meet the requirement. Only one service users had been admitted since the last inspection. The records showed that the placing agent had provided a detailed assessment. The assessment included the wishes of the service user and his expectations of the placement. An introductory visit to the home was organised prior to agreeing a trial stay. A review was held 4 weeks after the placement with the service user and family invited. The service user has not yet decided whether the placement will be made permanent. He did say that he was enjoying his
Parkfield Rest Home DS0000001217.V298347.R01.S.doc Version 5.2 Page 9 stay at the home; he liked the food, and had a good relationship with the staff and other service users. Parkfield Rest Home DS0000001217.V298347.R01.S.doc Version 5.2 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. The quality of the outcome in this area is good. This judgement was made using available evidence including a site visit. The records do reflect the social and health care needs of service user but they must be kept up to date. EVIDENCE: The care records for 2 service users were checked during the inspection. The care records are basic, however they do reflect the needs of the current service users. This includes basic health care needs. A care plan has been produced for each service user. The care plans are usually reviewed and up dated each month. However they had not been updated for the last 5 months. It is important that the care plans are kept up to date. The provider has produced individual day and night reports for each service user. The reports are very informative and provide good information of any progress or deterioration. The care records also provide a good picture of service users’ life history, which has been gleaned following discussions with the staff team. It was evident that the provider and the staff had a very good knowledge of the service users.
Parkfield Rest Home DS0000001217.V298347.R01.S.doc Version 5.2 Page 11 A medication check was not undertaken during this inspection, however it was noted that one service users’ medication was left out in the dinning area. The provider is reminded that all medication must be kept in lockable facilities. Parkfield Rest Home DS0000001217.V298347.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. The quality of the outcome in this area is good. This judgement was made using available evidence including a site visit. Service users are supported to keep their chosen lifestyles by staying independent and going out in the community. The service users enjoy their meals. EVIDENCE: The current service users are fairly independent and tend to organise their own activities. The 2 ladies enjoy shopping trips either on their own or with a staff member. Other service users go out on a regular basis using local facilities and public transport. The service user recently admitted to the home maintains regular contact with his family and enjoys attending church services and church functions. An annual holiday is organised each year, which is much enjoyed by all. The provider and the staff do try to introduce the service users to new experiences, however they do tend to be quite set in their ways. They tend to spend their time in the home sat chatting in the lounge and watching television. A record is kept of the food provided. They show service users are offered a wide range of different food and much of it is home made using fresh produce.
Parkfield Rest Home DS0000001217.V298347.R01.S.doc Version 5.2 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 and 17. The quality of the outcome in this area is good. This judgement was made using available evidence including a site visit. Complaints information is available, however the staff need formal adult protection training and more up to date local authority guidance information. EVIDENCE: Details of the complaints procedure are available. There have been no complaints since the last inspection. An adult protection policy and procedure are available together with a whistle blowing policy and procedure. Some information regarding the local authority No Secrets guidance is also available, however the full updated version needs to be obtained. At the last inspection it was a requirement that staff are provided with adult protection training. This has still not been completed. The inspector advised that the manager and deputy are prioritised. Parkfield Rest Home DS0000001217.V298347.R01.S.doc Version 5.2 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, 20, 21, 22, 23, 24, 25 and 26. The quality of the outcome in this area is good. This judgement was made using available evidence including a site visit. The environment meets the needs of service users and is maintained to a good standard of hygiene. EVIDENCE: A full building inspection was not undertaken during this visit. The inspector did see the bedrooms used by service users. They are a double on the ground floor and 2 singles on the first floor. The areas seen were kept clean, tidy and decorated to a reasonable standard. Some of the rooms did contain some personal items. The communal areas are located on the ground floor and were maintained to a good standard of hygiene. A stair lift is available to link the ground and first floors, however the service users living on the first floor are all ambulant and do not need to use it. Parkfield Rest Home DS0000001217.V298347.R01.S.doc Version 5.2 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 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 and 30. The quality of the outcome in this area is good. This judgement was made using available evidence including a site visit. The staffing was adequate for the numbers of service users living at the home. The recruitment procedures have improved. EVIDENCE: A vacancy still exists for a part time care assistant. The provider has had difficulty recruiting a suitable person to the post. One of the existing care staff is working extra hours to cover the post. The provider also has a pool of reliable casual staff to cover any hours required. All the staff team are employed to cover the day shifts. The provider/manager covers the night duties and lives on the premises. The current staff team has worked at the home for a number of years and are very familiar with the daily routines and the needs of the service users. The permanent staff have had CRB checks and the most recent staff have references. The recruitment procedure has improved over the recent years and the provider has now produced an application form and reference request forms. A new handyman has recently been employed. Verbal references were obtained prior to commencing employment. These must now be requested in writing. Parkfield Rest Home DS0000001217.V298347.R01.S.doc Version 5.2 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 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 and 38. The quality of the outcome in this area is good. This judgement was made using available evidence including a site visit. The home is well managed and service users have the opportunity to contribute to the decision making process. The service users and staff are provided with a safe environment. EVIDENCE: The home is run on a day to day basis by the provider/manager and an experienced member of the senior care staff. The staff team is very small and stable with information tending to be passed from staff to staff in an informal manner. However policies and procedures are available for key areas of work. Detailed health and safety information is available and staff are required to read and sign the information. Equipment safety checks are completed, however the electrical PAT tests are out of date and need testing. An accident
Parkfield Rest Home DS0000001217.V298347.R01.S.doc Version 5.2 Page 17 book is available and weekly fire safety checks are undertaken and recorded. Regular fire instruction is provided for the staff team. Parkfield Rest Home DS0000001217.V298347.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 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 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 2 Parkfield Rest Home DS0000001217.V298347.R01.S.doc Version 5.2 Page 19 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 Reg 15 Requirement The service user care plans must be kept up to date. They must be reviewed at least monthly. All service user medication must be stored in secure lockable facilities. Adult protection training must be provided for all staff. The senior care staff must be prioritised. (Timescale of 01/06/06 not met from last inspection) Written references must be obtained for the handyman The electrical PAT test is out of date. A qualified electrician must complete them. Timescale for action 31/08/06 2. 3. OP9 OP18 Reg 13(2) Reg 13(6) 01/08/06 01/10/06 4. 5. OP29 OP38 Reg 19 Reg 23 01/09/06 30/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Parkfield Rest Home DS0000001217.V298347.R01.S.doc Version 5.2 Page 20 1. OP18 An up to date copy of the local authority No Secrets guidance should be obtained. Parkfield Rest Home DS0000001217.V298347.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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