CARE HOME ADULTS 18-65
Parkgate Manor Catsfield Battle East Sussex TN33 9DT Lead Inspector
Jeanette Denereaz Key Unannounced Inspection 1st November 2006 09:30 Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 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 Parkgate Manor DS0000021184.V315833.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 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. Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Parkgate Manor Address Catsfield Battle East Sussex TN33 9DT 01424 773251 01424 777072 enquiries@parkgatemanor.co.uk 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) Mr Roger Williams Mr Brian Scarles Vacant Care Home 40 Category(ies) of Learning disability (40) registration, with number of places Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is forty (40) Service users must be aged thirty (30) years or over on admission Service users with a learning disability only to be accommodated Date of last inspection 18th October 2005 Brief Description of the Service: Parkgate Manor is a large detached house and provides residential care for up to 40 adults over the age of 30, with a mild to moderate learning disability. The home is set in extensive grounds, approximately 2 miles from the town of Battle. Residents’ rooms are on the ground and first floors, and there are a variety of attractive communal rooms. The gardens are also a well-used resource. The home has it’s own day centre, offering a range of opportunities in artistic, domestic and work related activities. The residents also access a wide variety of community events and educational facilities. The current scales of fees range from £460 to £600 per week. Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at Parkgate Manor are referred to as ‘residents’. This report reflects a key inspection based on the collation of information received since the last inspection and an unannounced site visit conducted by an Inspector on the 1st November 2006. The site visit included a tour of the premises and an examination of various records including medication, care and staffing records. The Inspector met with the new manager, staff members on duty and residents that were at home during this inspection visit. The residents were sent a ‘Have you say’ about Parkgate Manor survey, and nine were returned, and from information gathered residents were very happy with the care they received. Two residents requested to see the inspector, and they were interviewed and their comments were very positive about Parkgate Manor with one resident saying: “ I’m so happy here”. Also a resident that has only lived in the home for nine months, was also interviewed. He had previously lived in another care home in Hastings that closed in March 2006. He informed the inspector that: “It’s nice here, and the meals are nice”. What the service does well:
Parkgate Manor offers a good standard of accommodation, with some bedrooms offering en-suite facilities. The communal areas including the hallways are in the process of being decorated and new carpets to be fitted. The quality and quantity of the food is very good and the home has just appointed a new cook, and she discussed her plans with the inspector for offering healthier eating, but still offering the residents’ their favourite foods. However, at the time of the inspection visit, there was no record of the food eaten by residents. During this inspection process the manager has introduced a format for staff to record and monitor the consumption of food by the resident to ensure they are eating a balance diet. The home was again found to do most everything well, and continues to make improvements between inspections. The home was found to provide good support and the management team and staff are good at ensuring residents have a good and comfortable life. Staff spoke positively about the home, with and one staff member commented that:‘I didn’t intend to stay in this job so long, but the people are so nice”. Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 Page 6 The management team including the Proprietors are committed to providing a good quality of care for residents but also ensuring that staff are well supported. Parkgate Manor is very good at keeping families and friends informed about the home and there is a regular ‘Parkgate News’, which contains information about events and activities, staff changes and residents achievements. The parkgate news sent to families and friends in the summer contained the annual friends/relatives survey, and the results of this survey were published in the autumn parkgate news with comments: “We are extremely happy, and are amazed that you keep up such a busy schedule of activities. We could not suggest any activities that you don’t already do”. “I never had a reason to complaint, and hope I never will. The evening before this inspection visit the home had had its annual bonfire party, and residents and staff commented to the inspector that the evening had been very enjoyable. 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. The summary of this inspection report can be made available in other formats on request. Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 &5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The statement of purpose and service user guide clearly says what service will be offered. Prospective service users can be confident their needs will be assessed, and the home will meet their needs and aspirations. EVIDENCE: There have been two new residents since the last inspection. The two residents had very individual introductions to the Parkgate Manor, one resident came from another care home and the other was living with his family, and the pre-assessment information reflected the differences. The care home in which one of the residents was living in had closed and the information received by Parkgate Manor was not complete, and therefore the staff at Parkgate Manor have endeavoured to collate information from various sources and the profile now held on this resident is very comprehensive. The inspector had the opportunity to meet with him during this inspection visit and the resident confirmed he was very happy living at Parkgate Manor. Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 Page 9 The second resident came from his family home, and his introduction to the home was slower, with visits and overnight stays gradually increased. His family still have regular contact, and the inspector saw the correspondence between the home and the family to ensure the move for the resident and for them went as smoothly as possible. During the process of case tracking the two residents, the inspector reviewed their personal profiles and care plans. The contracts between the home and the sponsoring authorities were in place, but the individual contract and statement of purpose for the individual residents had not been completed. However, during this inspection process the manager ensured these documents were completed and are now in place. Copies of the contracts have been sent to the CSCI. Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. 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. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and staff demonstrate their knowledge of the individual residents, and are aware of the complex needs of the residents and encourage them to have an independent lifestyle as far as possible. EVIDENCE: It was evident that care plans are reviewed regularly and there is a pro-active key-worker system in place. The inspector interviewed the key worker to one of the new residents. The key worker had a good understanding of the resident and throughout the interview displayed his knowledge of the resident’s needs and aspirations. The resident, when interviewed spoke very complementary about his key worker, and had on occasion spoken about his previous home and that at times he had been unhappy, but he really liked living at Parkgate Manor. Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s links the local community are good and enrich residents’ lives socially and educationally. The social life within Parkgate Manor also enriches the residents’ lives, and their can choice from a variety of activities that they can enjoy and met their needs. EVIDENCE: The residents of Parkgate Manor have variety of activity options and as part of the inspection process the home gave the inspector a copy of the leisure/activities programme. The majority of residents are getting older and a slower lifestyle is reflected in their daily activities. However for the more active resident there is a full programme of activities including the day centre within Parkgate manor, other day services, college courses and other activities in the community. The grounds of the home are also cultivated as an activity, with plans to utilise this resource further.
Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 Page 12 The home has also been donated a poly-tunnel that will allow the residents to stay dry and warmer when gardening. The activity centre within the grounds of the home is used for craft and cooking activities. The two new residents are fully involved in the daily activities and one continues to attend his previous day service as this was assessed as being very important to him to continue to meet with his friends. The quality and quantity of the food is very good and the home has just appointed a new cook, and she discussed her plans with the inspector for offering healthier eating, but still offering the residents’ their favourite foods. However, at the time of the inspection visit, there was no record of the food eaten by residents. During this inspection process the manager has introduced a format for staff to record and monitor the consumption of food by the resident to ensure they are eating a balance diet. This document has been received by the CSCI. Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive personal support appropriate to their physical, emotional and healthcare needs. EVIDENCE: All residents are registered with local GP and health checks are regularly carried out and all personal and healthcare needs are well documented, including a full review for the two new residents. The residents receive, when requested or needed, support from the Community Learning Disability Team (CLDT). The medication files and storage were inspected and found to be in order. All staff that administers medication have had the relevant training and are all deemed to be competent in the administrating of medication. There has been review of the storage of the medication and now the secure room now only has medication stored.
Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 Page 14 The pharmacist employed by the Chemist that supply the medication to Parkgate Manor undertook an audit of the 16th October 2006 and the medication records, procedures and storage was found to be in order. The Inspector observed the procedures of giving out of medication during the lunchtime at the inspection visit, and she observed the procedures to be carried out in a sensitive, confident and confidential manner. Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives’ complaints would be taken seriously and investigated. The staff have the knowledge and understanding to take the correct action to safeguard residents from abuse. EVIDENCE: There are no recorded complaints or concerns since the last inspection. The home operates in an open and pro-active manner. The manager and staff demonstrated a sound understanding on how to prevent abuse, with most staff having relevant training in this area, which was confirmed by the training matrix dated 29th September 2006 in which 17 staff have received training. Residents interviewed during this inspection visit informed the inspector that they are very happy living at Parkgate Manor and if they were unhappy they would always speak to the staff or the manager. As part of the annual Parkgate Manor friends and relatives survey 2006, people were asked if residents, friends and families were generally happy with the service the home provides. The response was positive with comments made: “I have never had any reason to complain, and hope that I never will” “If we have any concerns, they are acted upon very quickly”. Since the last inspection the home now has introduced a new banking system for residents’ monies, which avoids the pooling of money, and a formula is now used to accurately calculate the interest accrued by the individual resident.
Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 Page 16 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The overall standard of the environment including the décor and furnishing are good and provide a homely and attractive place for residents to live. EVIDENCE: The Inspector toured communal parts of the home such as lounges, bathrooms and dining areas along with hallways finding them all to be clean. She also viewed a few bedrooms. There is a range of comfortable communal areas, which are all well used by the residents with most having comfortable chairs and a television. The manager has a maintenance and renewal plan that over the next six months she will undertake an audit of all the bedrooms to ensure they are all in good decorative order and have good quality furnishings.
Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 Page 17 The inspector was shown one vacant room, which has had the audit, and the room was decorated and furnished to a good standard. There was one toilet that was in need of urgent decorating, this was identified as a staff toilet. However, the inspector was notified during this inspection process that the toilet has been decorated. During this inspection visit, decorating was taking place along the main stairway and this is an ongoing activity as part of the maintenance schedule to ensure the home is always in good decorative order. After the decorating in the hallway the manager informed the inspector that the lounges would be also decorated. The plan is to decorate the home in more natural colours and paintings and prints to be hung on the walls. It was noted by the inspector that the home was much lighter and inspite of the decorating the home was very clean and free from offensive odours. Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 Page 18 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34, & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The overall standard of the environment including the décor and furnishing are good and provide a homely and attractive place for residents to live. EVIDENCE: The inspector observed the staff working with the residents and was impressed with the respect and empathy shown by all the staff on duty. When questioned the staff had a good knowledge of the residents, and gave the residents a personal touch to their care, this is achieved by the established staff team working well together. Training is very important to the management and the staff and all are encourage by the manager and proprietor to undertake training. The inspector during this inspection visit reviewed the staffing records of the two newest staff members and the documentation was in order. The inspector had the opportunity to speak with the maintenance person, and he expressed that he enjoyed his work, and all the staff and management are very supportive.
Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42 Quality in this outcome area are good. This judgement has been made using available evidence including a visit to this service. Parkgate Manor is openly and exceptionally well managed in the best interests of residents who are fully involved in the running of the home. The home benefits from a well-motivated manager, who is supported by motivated Proprietors and enthusiastic staff team. A safe environment is maintained for residents with them protected from harm by well-trained staff. EVIDENCE: Since the last inspection the home now has a new manager, she is very experienced and has had managerial positions in other care homes.
Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 Page 20 She is in the process of making application to the CSCI to become the registered manager of Parkgate Manor. Records showed that all aspects of health and safety were being met this included looking at appliance safety certificates, staff training, and accident records. All staff receive regular mandatetory training and training that has taken place since the last inspection as been in Moving and Handling training, fire safety, food hygiene and Medication administration. All accidents and significant incidents are promptly reported to the CSCI. Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 Parkgate Manor DS0000021184.V315833.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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
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