CARE HOME ADULTS 18-65 PARKHILL LODGE Larch Road Maltby Rotherham S66 8AZ
Lead Inspector Rosemary Reid and Mike Siegal Unannounced 11 April 2005 09:00. 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. PARKHILL LODGE Version 1.00 Page 3 SERVICE INFORMATION
Name of service Parkhill Lodge Address 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) Larch Road Maltby Rotherham South Yorkshire 01709 813040 01709 790325 None Rotherham Metropolitan Borough Council Lilian Rigby CRH 22 Category(ies) of Learning Disability 22 registration, with number of places Conditions of registration Date of last inspection YES 11 January 2005 Brief Description of the Service: Parkhill Lodge is owned and operated by Rotherham Metropolitan Borough Council. It is a care home offering accommodation for people with learning disabilities on a long stay, short stay and respite care basis. The home provides accommodation for up to 22 people in single room accommodation. The home is situated in its own grounds with gardens and patio area and is within walking distance of Addison Day Centre. The home is only a short bus journey on routes 101 and 102 from Maltby. PARKHILL LODGE Version 1.00 Page 4 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over 9 hours from 9:00am to 18:30. The lead inspector had not visited the home previous and was accompanied with an inspector who was on an induction programme. Six of the eight staff on duty, fifteen of the nineteen residents and one relative were spoken with over the period of the inspection to collate their views about the care given at the home. Notices were placed around the home to inform residents, staff and visitors to the home that an unannounced inspection was taking place. Twenty comment cards and prepaid envelopes were left at the home so that residents or their representatives can contact the CSCI with their views about the home. The inspection focused on the requirements from the previous inspection, five residents files were case tracked along with medication, staffing rota, complaints, Adult Protection and Health & Safety issues for the safety and well being of the residents at Parkhill Lodge. What the service does well:
The majority of the staff have worked at the home for many years, which provides continuity for residents. Staff were observed to have good rapport with residents. Residents and one relative who was visiting the home confirmed that staff were caring, the home was always kept clean and tidy, and that service users did chose furnishings in their bedrooms. There is a varied activities programme in and outside the home and this was confirmed by residents, relative and by observation. Meals are varied and service users said they enjoy their meals. All of the service users and the relative spoken with were satisfied with the delivery of care and had no complaints. Only one complaint had been recorded and action was taken by the manager, which advances residents’ rights. The local pharmacist had visited and left a satisfactory report. Medication records were examined and found to be correct which helps to promote service users’ health. Health and Safety records were examined and found to be up to date. Rotherham Metropolitan Borough Council has a Quality Assurance system and audits are undertaken on a monthly basis cover different areas of care within the home. Monitoring visits are undertaken by the Line Manager on a monthly basis. Three domestics have achieved their NVQ level 1. The home was tidy, clean with no offensive odours. PARKHILL LODGE Version 1.00 Page 5 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. PARKHILL LODGE Version 1.00 Page 6 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 Standards Statutory Requirements Identified During the Inspection PARKHILL LODGE Version 1.00 Page 7 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 - 4 The home had a Statement of Purpose and the Service User Guide had been reprinted. However it had not been distributed to residents, which did not give residents the information about the services that the home provides. It is the intention of the manager to ensure that potential and new service users will be given the Service Users Guide to enable them to make a choice about whether or not they might wish to live at Park Hill Lodge. The Service User Guide has pictorial support. EVIDENCE: On the second visit to the home the updated version of the Service Users Guide was in place. Four Service users said they had read the new Service User Guide. Five files were case tracked, which included a social worker assessment, which also included a financial assessment and the portion that each service user had to pay for their care and accommodation. Through discussion with residents and a relative confirmed that visits for potential service users and their families have taken place. PARKHILL LODGE Version 1.00 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6. The home has a care plan system and work is needed to ensure that residents changing needs and direction for staff are included within the care plan to support residents in their day-to-day life at Parkhill Lodge. EVIDENCE: Each service user has a file. One of the five care plans examined did not have a plan of care for the resident who was on long-term respite care. The other four care plans do not address service users changing needs or direct staff to care for those residents. Daily working notes were up to date. Five care files were examined and there were risk assessments in place. However, the care plans did not show the changing needs for service users for example a resident who had a fall had sustained a fracture had important information but the care plan had not been updated to include important factors. The resident was seen to be given care but there was no evidence to support the direction in the care plan that staff were asked to with regard to the changing needs of this service user. PARKHILL LODGE Version 1.00 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14 & 17 The home provides a range of activities both in and out of the home for the stimulation and enjoyment, which benefits residents. Residents have options at meal times. Menus are formulated to include the likes of the service users. EVIDENCE: Three residents were seen doing painting, another was knitting and a further two service users were relaxing in their bedrooms listening to music. There were notices advertising a “Race Night” at a local club, which staff were arranging and service users would be attending (if they wanted). Depending on assessment service users attend college or day care facilities. Staff were seen asking residents what they wanted for the lunchtime snack with the main meal being served in the evening. The residents and one relative who spoke with the inspectors said that they enjoyed the meals and had no complaints about the quality or quantity of meals prepared at Parkhill Lodge.
PARKHILL LODGE Version 1.00 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19, & 20 The ethos of the home promotes dignity, respect and independence with the service users taking part in self-advocacy meetings. Residents and relatives are informed of advocacy services, which promote and advance residents’ rights. Residents’ physical and emotional health care needs were met by the involvement of doctors, hospital, physiotherapists and occupational along with the community nurses. Medications were administered as prescribed and the staff at the home work to their medication policies, which promotes the wellbeing of residents. EVIDENCE: The Statement of Purpose, the Service User Guide, the induction programme for staff, along with the policies refers to dignity respect and independence. In discussions with residents they said they were treated with respect and dignity and this was confirmed by a relative who visited the home at the time of inspection. Staff members were seen to knock on bedroom doors. The home’s diary and care records show that there was involvement the Primary Care Team and appointments kept at hospital/clinics. The home’s manager and the manager of the day centre have regular meetings to discuss issues and to keep up to date with residents’ progress/ regression. Medication records were examined which were satisfactory. The pharmacist visited on the 31st March and left a report without any requirements or recommendations.
PARKHILL LODGE Version 1.00 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 The Local Authority and the home have policies and procedures to protect residents from abuse. The home has a clear complaints system, which residents and relatives have used to record their grievances and/or concerns. EVIDENCE: Staff listen to residents’ views through residents meetings and in discussions with staff along with making complaints through the complaints process. The home has a complaints policy and records show that a number of service users made a complaint and action had been taken by the manager to resolve their grievances. However, records do not show that the residents were contacted by the investigating officer with the outcome of the investigation. There have been no Adult Protection investigations since the previous inspection. Rotherham Metropolitan Borough Council has policies on Adult Protection matters. Records show that all new staff goes through the induction programme, which includes Adult Protection issues. The next training course on Adult Protection is in June 2005. PARKHILL LODGE Version 1.00 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 & 27 The home is suitable for its stated purpose and residents stay in a comfortable, homely, safe environment. The home has sufficient number of toilets and bathrooms for residents’ needs EVIDENCE: There are three bathrooms and one shower-room with toilets along with six toilets. The home was clean and without offensive odours. The domestics were observed working in all areas of the home. PARKHILL LODGE Version 1.00 Page 13 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 & 35 The home has appropriate staffing levels that support residents in their day-today needs. The home is not in a position to ensure that 50 of care staff have achieved NVQ level 2 by the end of 2005. EVIDENCE: The majority of the staff group have worked at the home for many years and have developed a variety of skills. The parent organisation has a training department and there was evidence that staff had attended training courses. The training plan for the home was examined, which showed that names of staff had been submitted in July 2004 for NVQ level 2. However, no further developments had taken place to ensure that 50 of care staff that work at the home have achieved NVQ level 2 by the end of 2005. Training for staff is dependent on the training department putting on courses. Records did not show that staff had attended courses on understanding Learning Disability or Challenging Behaviours. PARKHILL LODGE Version 1.00 Page 14 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 & 42 The manager promotes the health, safety and welfare of residents. EVIDENCE: Audits are undertaken and monitoring visits are undertaken on a monthly basis. The CSCI has received an application for a variation to include Older People to their registration certificate, which is being processed. The home has a fire assessment and fire prevention training had been undertaken. Records show that Health & Safety procedures were undertaken and certificates were up to date. PARKHILL LODGE Version 1.00 Page 15 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. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 2 x x x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x 3 x x x Standard No 11 12 13 14 15
PARKHILL LODGE x x x 3 x Standard No 31 32 33 34 35 36 Score x 3 x x 2 x Version 1.00 Page 16 16 17 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x x 3 PARKHILL LODGE Version 1.00 Page 17 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard NMS YA 6 Regulation Reg 15, Sch 3(1)(b) Requirement The registered person must ensure that each service users have a care plan. Care plans must address service users changing needs and direct staff to care for residents. Timescale for action 1st July 2005 2. 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 NMS YA 3 Good Practice Recommendations It is recommended that care staff be enrolled on NVQ level 2 to ensure that 50 of the staff achieve It is also recommended that staff have training in challenging behaviour. PARKHILL LODGE Version 1.00 Page 18 Commission for Social Care Inspection 1st Floor, Barclay Court Heavens Walk Doncaster DN4 5HZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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