Inspection on 12/05/05 for Parkfields

This inspection was carried out on 12th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Parkfields 25/10/07

Parkfields 08/01/07

Parkfields 11/05/06

Parkfields 15/12/05

Parkfields 05/10/04

Parkfields 01/06/04

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Parkfields Nursing Home 556 Wolverhampton Road East Parkfields Wolverhampton WV4 5AF Lead Inspector Rosalind Dennis Unannounced 12 May 2005 11.00 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 and Care Homes for Adults 18 – 65*. 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. Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Parkfields Nursing Home Address 556 Wolverhampton Road East, Parkfields, Wolverhampton, WV4 5AF 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) 01902 621721 01902 339915 Dr Mohan Lal Passi Miss Cheryl Fenton Care Home with Nursing 49 Category(ies) of PD(E) physical disability- over 65 (50) registration, with number TI terminally ill (3) of places PD physical disability (50) Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1) No number division between categories except 3 (only) palliative care, and 5 (only) intermediate care. 2) The manager (Cheryl Fenton) must obtain NVQ 4 in Management of care or equivalent within 2 years of approval. Date of last inspection 05/10/2004 Brief Description of the Service: Parkfields Nursing Home is a privately owned care home registered with the Commission for Social Care Inspection to provide nursing care to 49 people with physical disabilities aged over and under 65 years of age. It is also registered to provide palliative care for three people with a terminal illness. The Home is owned by Dr Mohan Lal Passi and Dr Uma Passi. Ms Cheryl Fenton is the registered manager and has day to day management responsibility for the Home Parkfields Nursing Home is two-storey, purpose built accommodation set in attractive grounds with parking at the front and gardens to the side and rear. The Home is situated close to Wolverhampton city centre, on a public transport route and with shops and local services nearby. Care and nursing is provided in modern accommodation offering well-equipped single rooms. 22 bedrooms have en-suites all other bedrooms have a handwash basin. The communal areas comprise of 3 lounges and a separate dining area. There is a passenger lift to access the first floor. Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 12th May 2005 and lasted for a period of six hours. The inspection included observing activity within the home, a tour of the premises, looking at care records and observation of documents. The inspector also spoke with residents, relatives and staff that work at the home. A recent anonymous complaint received by CSCI was investigated as part of this inspection; the complaint was not upheld. The manager was not on duty at the time of inspection however the home was functioning well in the presence of the deputy manager who, along with other staff on duty offered their fullest co-operation throughout the inspection. What the service does well: What has improved since the last inspection? The home has recently achieved the Investors In People Award. Carpets that were identified as soiled in the previous inspection report have been replaced. The home has met twelve out of sixteen requirements that were issued at the last inspection. Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc Version 1.30 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. Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Standards Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6-10 and 18–21) (Standards 11–17) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37–43) Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. 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. Prospective service users have an opportunity to “test drive” the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 4 Staff individually and collectively have the skills and experience to deliver the care which the home offers to provide EVIDENCE: Through discussion with residents, visitors and observation of staff working with residents the home demonstrates that it meets the needs of the current residents. To seek the views of an Asian resident a member of staff translated for the inspector and the resident was able to confirm that the home met his needs and he was happy with the care provided. The manager and deputy manager have attended recognised training in palliative care. Training certificates in staff files demonstrate that staff have the knowledge and skills to meet the needs of the current residents. Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6-10 and 18 –21 (Adults 18-65) 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. Including their physical and emotional health needs. 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. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. Service users receive personal support in the way they prefer and require. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 7, 9, 18, 19 and 20 (Adults 18-65) are 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 and 11 There is a clear and consistent care planning system in place, which provides staff with the information they require to meet residents’ needs. The health care needs of residents are met by the staff in the home and by specialist healthcare professionals who visit the home on a regular basis. The process employed for recording the administration of medication is not acceptable and could potentially place residents at risk. Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc Version 1.30 Page 10 EVIDENCE: Within three residents care files inspected there was good evidence to confirm that health care needs are met. Qualified nursing staff review care plans and assessments on a regular basis and of the files checked care plans and risk assessments were up to date and appeared appropriate for the resident. One member of qualified staff was able to give a thorough and accurate account of the care for a particular resident that she was looking after. Visits from other healthcare professionals were recorded in each file. Comprehensive wound care assessments, photographs and plans provide staff with the information they need to perform wound care although the home is advised to obtain written consent from residents or their relatives prior to taking photographs of wounds. The resident’s weight charts demonstrate that residents are weighed monthly. There was a gap in the recording on one weight chart which the deputy manager reported was due to the resident’s general condition. The home is advised to record the reason for not weighing individual residents. The inspector spoke with six residents who commented positively about the care they receive. Two relatives who visited the home during the inspection said that they were regularly consulted about their relatives care and notified promptly by staff if there was a change in their relative’s condition. The manager and deputy manager have undertaken courses to equip them with the knowledge and skills to provide palliative care with specialist support and guidance provided by community hospice staff as required. The sensitive matter of establishing and recording resident’s wishes regarding terminal care and arrangements after death is in progress. Medication administration is restricted to qualified nursing staff. Record sheets however are not being completed at the time of administration of medication. The deputy manager described a system of completing the drug record sheets at the end of the drug round which is not acceptable and inspecting the record sheets highlighted several occasions when staff had not signed to say whether medication had been given. The medication policy which authorises staff to administer certain over the counter medication preparations had not been dated or signed by individual resident’s GP’s and therefore requires amendment. To ensure that drugs are stored at the correct temperature the home must start monitoring the temperature of the drug treatment room and alter the way it monitors the drugs fridge temperature. Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 11 – 17 (Adults 18-65) are: 12. 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. Including opportunities for personal development. Service users engage in appropriate leisure activities. Service users maintain contact with family/ friends/ representatives and the local community as they wish. And have appropriate personal, family and sexual relationships. 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. 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15, 16 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 14 The staff work closely with residents and their significant others to establish individual preferences and promote choice. The home provides social and recreational activities that provide variation and interest for people living in the home. EVIDENCE: Observation of the activities book and residents care files demonstrates that the home provides a range of activities in-house for resident’s to take part in if they choose. Some residents enjoyed a bingo session during the afternoon of the inspection, other residents reported that they had chosen not to take part and preferred to sit quietly or talk with staff. Activities in the wider community are also accessed and the home has previously arranged canal boat trips and visits to a local park. Relatives reported that they visit the home at different times of the day and receive a warm welcome from all staff each time they visit. The visitor’s book showed considerable activity. Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc Version 1.30 Page 12 The process of assessing the provision of meals was not undertaken at this inspection, however during conversation all residents commented that a choice of meal is always offered. Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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. Including neglect and selfharm. The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The complaints process in this home is not satisfactory with little information available to residents and/or their significant others on the complaints process. The home is still to provide further adult protection/abuse awareness training for staff to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: Residents reported that they would notify the manager or deputy manager if they were unhappy with any aspect of their care. However the complaints procedure available on the notice board in the reception area does not contain sufficient information to meet legislative requirements and it is not accessible to all residents. The home has a policy in place with regard to the protection of residents from abuse. Staff confirmed that they would not hesitate in reporting suspected abuse but were unable to define the whistle blowing policy. The previous inspection identified the need for further staff training in adult protection procedures, this has not been undertaken as yet. Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) 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. Shared spaces complement and supplement service users’ individual rooms. Service users have sufficient and suitable lavatories and washing facilities. Provide sufficient privacy and meet their individual needs. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. And lifestyles. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 23, 25 and 26 The standard of the environment in this home is good providing residents with an attractive, clean and homely place to live. EVIDENCE: The home has three lounges and a dining room, which therefore provides residents with a choice of communal spaces. All bedrooms are single rooms that either have en-suite facilities or are fitted with a wash hand basin. The home was observed to be clean and well maintained and residents confirmed that they were satisfied with their bedrooms and with the cleanliness of the home. New carpets have been fitted in the corridor and furnishings and fittings in all parts of the home are of good quality. On the day of inspection systems were observed to be in place to control the spread of infection and staff were observed utilizing protective clothing and Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc Version 1.30 Page 15 hand-washing facilities. Maintenance records checked showed that water temperatures are maintained at the required temperature. Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 36 (Adults 18-65) are: 27. 28. 29. 30. • • • Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. 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. Service users benefit from clarity of staff roles and responsibilities. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers standards 27, 29 and 30 (Older People) and Standards 34 and 35 (Adults 18-65) the key standards to be inspected at leat once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29 The home has a stable group of staff, employed in sufficient numbers to meet the needs of each resident in a sensitive and professional manner. The procedures for the recruitment of staff are not robust which potentially could result in the employment of inappropriate staff. EVIDENCE: Staffing levels remain at two first level nurses in the morning plus seven care staff, two first level nurses in the afternoon/evening plus seven care staff and two first level nurses and three carers at night (or one nurse and four carers). Residents reported that the level and competence of staff was sufficient to meet their needs and staff also felt that the levels were adequate. Domestic and laundry staff are employed in sufficient numbers to provide a daily service. A sample of three staff files identified deficits in the home’s recruitment practice. Three files did not contain application forms, two files did not contain written references, recent photographs were not present on file and there was no evidence of a health declaration being completed by these employees. CRB Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc Version 1.30 Page 17 disclosures were present in the files examined. The deputy manager reported that prospective staff sometimes come to the home informally to see if there are any vacancies and may not always complete an application form. This therefore results in the home not obtaining a full employment history prior to the individual commencing employment. Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 37 – 43 (Adults 18-65) are: 31. 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 a well run home and from competent and accountable management of the service. 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. Service users are confident their views underpin all self-monitoring, review and development by the home. 32. 33. 34. 35. 36. 37. 38. • The Commission considers standards 33, 35 and 38 (Older People) and Standards 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 38 There are clear lines of accountability within the management structure and the management approach creates an open and positive atmosphere from which residents and staff benefit. The health, safety and welfare of residents are promoted by a safe and well maintained working environment. EVIDENCE: Residents and their visitors made positive comments about the staff team and the management structure and a discussion with staff confirmed a supportive manager and deputy manager. Although the manager was not on duty the home was observed to be functioning well in the presence of the deputy Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc Version 1.30 Page 19 manager and staff were observed to be carrying out their duties in an enthusiastic and professional manner. The home has a full time maintenance person and all records pertaining to the maintenance and servicing of equipment were well organised and up to date. Staff have attended recent fire safety training and evidence of attendance was available in a selection of staff files seen. Bed rails that were in use were fitted correctly and residents appropriately risk assessed, the home is advised to incorporate the general maintenance of bed rails into a planned preventative maintenance programme. The document for the recording of accidents does not conform to the Data Protection Act and the home is required to obtain a new accident book that conforms to the legislative requirement. Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc Version 1.30 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 x 2 x 3 x 4 3 5 x 6 x HEALTH AND PERSONAL CARE ENVIRONMENT Standard No 19 20 21 22 23 24 25 26 STAFFING Score 3 3 x x 3 x 3 3 Score Standard No 7 8 9 10 11 Score 3 3 2 3 3 Standard No 27 28 29 30 3 x 2 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No 16 17 18 Score 2 x 2 MANAGEMENT AND ADMINISTRATION Standard No Score 31 x 32 3 33 x 34 x 35 x 36 x 37 x 38 3 Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc Version 1.30 Page 21 Yes 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 9 Regulation 13(2) Timescale for action All medicines administered/not The home administered must be recorded states this immediately after the transaction has been with either a signature or a completed. defined abbreviation so that gaps in the administration record do not occur. The home must commence The home montitoring the temperature of states this the treatment room to ensure has been that the temperature does not completed. exceed 25 degrees C. The homely remedies medication The home policy must be amended to staes this include authorisation from has been individual residents GP and completed. dated. The complaints procedure must The home be reviewed and updated and states this must be in a format suitable for has been the service user group.(Previous completed. timescale of 30/11/04 not met.) The registered person must 1/09/05 ensure that all staff receive additional training in adult protection procedures and recognising and dealing with adult abuse.(Previous timescale of 31/03/05 not met. The registered manager must be The home Version 1.30 Page 22 Requirement 2. 9 13(2) 3. 9 13(2) 4. 16 22 5. 18 12(1), 18(1) 6. 27 12(1) Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc 7. 29 19, Schedule 2 8. 36 18(2) 9. 38 17 supernumery and must not be included in the staffing numbers. Compliance not assessed at this inspection, previous timescale of 31/12/04. The registered person must ensure that information and documents as required by Regulation 19 Schedule 2 are obtained prior to commencement of employment, including a full employment history. Copies of these documents must be retained on each staff file. All care staff must receive formal recorded supervision at least 6 times per year. Compliance not assessed at this inspection. Accidents must be recorded in a format that conforms to the Data Protection Act. states this has been completed. 1/08/05 1/09/05 1/09/05 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. 4. Refer to Standard 8 8 38 9 Good Practice Recommendations The home is advised to obtain written consent from residents or their significant others prior to photographing wounds. If it is not appropriate to weigh a resident then the home should record the reason why the resident has not been weighed. The home is strongly recommended to commence a planned preventative maintenance programme regarding the use of bed rails. The monitoring of the temperature of the drugs fridge should indicate a daily minimum and maximum temperature. Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 2nd Floor, St Davids Court Union Street Wolverhampton WV1 3JE 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 Parkfields Nursing Home E56 000017196 Parkfields Nursing Home V226595 120505 UI Stage 4.doc Version 1.30 Page 24 - 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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