Inspection on 17/03/06 for Parkhill Nursing Home

This inspection was carried out on 17th March 2006.

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

Parkhill Nursing Home 26/06/07

Parkhill Nursing Home 23/08/05

Parkhill Nursing Home 02/03/05

Parkhill Nursing Home 05/10/04

Parkhill Nursing Home 24/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Parkhill Nursing Home 319 Huddersfield Road Stalybridge Tameside SK15 3EP Lead Inspector Mrs Fiona Bryan Unannounced Inspection 17th March 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 Parkhill Nursing Home DS0000025448.V283833.R01.S.doc Version 5.1 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. Parkhill Nursing Home DS0000025448.V283833.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Parkhill Nursing Home Address 319 Huddersfield Road Stalybridge Tameside SK15 3EP 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) 0161 303 8643 0161 338 6910 parkhillcare@btinternet.com Belmont Parkhill Limited Mrs Christine Holland Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38), Physical disability (10), Physical disability of places over 65 years of age (38) Parkhill Nursing Home DS0000025448.V283833.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Services Users to include up to 38 PD(E), up to 38 OP and up to 10 PD. The registered manager to be supernumerary for 27 hours per week. A minimum of 238 qualified staff hours to be deployed per week. No more than 10 service users to be admitted who are between the ages of 39 and 65 years. 23rd August 2005 Date of last inspection Brief Description of the Service: Parkhill Nursing Home is a late Victorian building with a purpose built extension, situated on Huddersfield Road, a short distance from Stalybridge town centre. The home provides nursing care for up to 38 service users and provides within that figure for up to 10 younger adults who are disabled or service users who require personal care only. Accommodation is provided over three floors in primarily single rooms, although a number of shared rooms are available. Some rooms have en-suite facilities. Lounge and dining areas are available on each floor, in which service users can socialise and participate in activities taking place within the home. In addition, there is access to patios and garden areas with open views of the surrounding countryside. Parkhill Nursing Home DS0000025448.V283833.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 17th March 2006 and was the second inspection of the year. It was undertaken by one inspector who spent time talking to residents, visitors and staff. At the last inspection in August 2005 the home was performing satisfactorily in many areas so the purpose of this inspection was to review progress in the areas that were identified as needing improvement. This was mainly related to how residents’ care plans were developed and reviewed, the arrangements for dealing with medicines, and training for staff in specific topics such as the prevention of abuse. Six key standards, which have to be assessed at least once year were not examined at the last inspection, and were therefore considered at this inspection. These standards included how the home dealt with staff recruitment and residents’ personal finances, how residents’ choices and rights are upheld, the training and qualifications of the manager and staff and health and safety procedures. Standards which were not assessed at this inspection, were considered to be satisfactory at the last inspection. For further information about how the home met these standards please refer to the report of the inspection on 23rd August 2005. What the service does well: Residents and visitors were very complimentary about the home. One resident said she was very happy and settled at the home and there were “lovely staff”. A visitor said she was very happy with the care her relative received and said staff were helpful and friendly. Another resident said the home was “smashing”. Two workmen who have spent a lot of time at the home recently, fitting carpets, said they had noticed that staff worked hard and always seemed busy, getting on with their jobs when they were at the home. They had noticed that if residents rang their nurse call buzzers for help staff always went to see them straight away. Parkhill is a very well maintained, clean, homely and comfortable environment and residents said they liked their rooms and were very satisfied with the cleanliness of the home. 50 of care staff have completed NVQ training successfully and other staff are currently undertaking the training. Parkhill Nursing Home DS0000025448.V283833.R01.S.doc Version 5.1 Page 6 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. Parkhill Nursing Home DS0000025448.V283833.R01.S.doc Version 5.1 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 Parkhill Nursing Home DS0000025448.V283833.R01.S.doc Version 5.1 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): None of the standards in this section were assessed. EVIDENCE: Parkhill Nursing Home DS0000025448.V283833.R01.S.doc Version 5.1 Page 9 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 and 9 More rigour is needed to ensure that care plans fully address all the residents’ needs and provide staff with enough information to ensure that residents’ healthcare needs are met. Failure to follow policies and procedures in respect of the administration of medicines puts the residents at risk. EVIDENCE: Examination of a selection of care files indicated that whilst care plans had been developed to address residents’ needs they were often somewhat vague and needed more detail to ensure it was clear how the resident’s needs were to be managed and care evaluated. For example several care plans did not contain details of the pressure relieving mattresses required by residents etc. and in the case of alternating pressure mattresses, the care plans did not state at what setting the pump should be maintained – this information would help staff ensure that the mattress was working properly and was set at the most effective level for the resident. Parkhill Nursing Home DS0000025448.V283833.R01.S.doc Version 5.1 Page 10 Care plans that had been developed for residents at risk of pressure sores did not specify how their care was to be monitored – if residents need to be assisted to change position this should be recorded. Risk assessments had been undertaken for pressure areas and moving and handling but not for residents’ nutritional status. The home maintains very good contact with residents’ GP’s and will often liaise by email. However, instructions from the GP are not always transferred to the resident’s care plan, leading to the possibility that the advice or instructions may be overlooked. The home has a small team of permanent staff and rarely has to employ temporary staff and therefore tends to communicate information verbally – however records need to be kept as accurately as possible to ensure continuity of care in the absence of regular members of staff. Medication administration records (MAR charts) were examined on the ground floor of the home. Residents are identified prior to medication administration by the use of photographs attached to the medication administration records. Staff members with responsibility for medication administration can be identified by the means of a staff signature sheet, which is located in the medication administration record file. On occasions where a variable dose of medication was prescribed, for example, one or two tablets to be taken, the actual dose administered was not recorded. On a number of occasions medication administration details had been handwritten. These transcribed details had not been signed or dated or validated by an additional member of staff. Records for the receipt of medication by the home were not always completed. The treatment room on the ground floor is only small and therefore needs to be kept as tidy as possible to maximise space. Staff also need to ensure that they check quantities of stock prior to re-ordering and cancel delivery of medicines if a resident is in hospital. One resident who was prescribed Fentanyl patches which only have to be administered once every 72 hours had 25 patches which would be enough for over 10 weeks administration. Parkhill Nursing Home DS0000025448.V283833.R01.S.doc Version 5.1 Page 11 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): 14 Residents feel they are treated as individuals and are able to exercise choice where possible. EVIDENCE: Residents said they were able to get up and go to bed as they wished. At the time of the inspection several residents were in their own rooms out of choice and all the residents knew that some entertainment had been planned for that afternoon and were looking forward to joining in. Residents said that they felt staff treated them as individuals and knew their routines and preferences. Staff were observed to be asking residents rather than telling them in respect of tasks such as taking them to the bathroom. Parkhill Nursing Home DS0000025448.V283833.R01.S.doc Version 5.1 Page 12 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): 18 Procedures within the home and staff training ensure that residents are protected from abuse. EVIDENCE: Since the last inspection a small number of staff have received training in challenging behaviour and others have undertaken training in the protection of vulnerable adults. Staff who have completed NVQ training have covered the prevention of abuse as part of that training. The manager stated that training in these topics would be ongoing until all staff have undertaken it. Residents said they felt safe at the home and were happy to speak with either the manager or deputy manager if they had any concerns or complaints. Parkhill Nursing Home DS0000025448.V283833.R01.S.doc Version 5.1 Page 13 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, 21,24 and 26 The standards of décor and furnishing within the home are very high and this together with the pride staff have in the environment ensures that residents are provided with a safe, comfortable and very pleasant home in which to live. EVIDENCE: On the day of the inspection new carpets were being laid in several rooms – this was completing a programme whereby all carpets have been replaced over the last 12 months. The maintenance person was painting woodwork in a resident’s bedroom and all areas of the home were immaculately maintained to a very high specification. All the bathrooms and toilets have been repainted and were due to be fitted with new cushion flooring. Bathrooms looked homely, bright and very clean. On the ground floor one bath has been replaced with a disabled shower which staff said residents often preferred as it was much more convenient for them Parkhill Nursing Home DS0000025448.V283833.R01.S.doc Version 5.1 Page 14 to access. The home does still have several baths for residents who prefer them. Since the last inspection the majority of bedrooms have been provided with new furniture, which is of a really high quality and well suited to residents’ needs, being very spacious. All of the residents’ rooms were personalised with their own ornaments, photographs and mementos. Residents said they loved their rooms and they were very satisfied with the standard of cleanliness and hygiene. All areas of the home were spotlessly clean and no malodours were detected. Parkhill Nursing Home DS0000025448.V283833.R01.S.doc Version 5.1 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): 28, 29 and 30 The home meets the standard for the percentage of care staff who have NVQ’s and this together with the provision of other staff training ensures staff have the skills and knowledge to care for the residents competently. Recruitment practices protect the residents. EVIDENCE: 11 of the 21 care staff working at the home have successfully completed NVQ training. Another 4 carers are currently working towards the NVQ level 2. Examination of 3 staff personnel files indicated that POVA First checks were carried out prior to new staff commencing employment. Files contained employees’ application forms with employment histories, relevant references, proof of identity, induction records and certificates of qualifications and training and records of supervision. Training is well organised and takes into account the needs of the residents and the skills and knowledge of the staff. Some staff have undertaken training in epilepsy, others in care of the dying or continence awareness, dementia care or the management of medicines. The nurses have received training in risk assessment related to moving and handling. One member of staff had undertaken training in the management of diabetes. First aid training is planned for April 2006. Parkhill Nursing Home DS0000025448.V283833.R01.S.doc Version 5.1 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, 32, 33, 35 and 38 The manager is well qualified and competent to safely manage the home but needs to complete the Registered Managers Award to fully comply with this standard. The home’s procedures safeguard the financial interests of the residents. Staff training and adherence to policies and procedures ensure that the health and safety of residents and staff are protected. EVIDENCE: The manager has undertaken a variety of training over the past year and is arranging funding for herself and the deputy manager to undertake the Registered Managers Award commencing in April 2006. There are clear lines of accountability in the home, which leads to consistency of care and high morale within the work force. Staff understand their Parkhill Nursing Home DS0000025448.V283833.R01.S.doc Version 5.1 Page 17 responsibilities and policies are carried out properly, for example it was pleasing to note that sickness and absenteeism was managed robustly with staff being required to complete “return to work” forms so any potential reasons for non attendance, lateness or unreliability could be identified and resolved. Since the last inspection the registered provider has visited the home on regular occasions and a report of each visit has been forwarded to the CSCI. The majority of residents are assisted with their finances by their families. Most residents have private bank accounts into which their pensions are paid and their families are invoiced for any sundry expenses such as hairdressing and newspapers. Some families choose to leave a “float” at the home and will top this up as the resident spends it. Receipts are kept of all transactions and individual ledger sheets detail how much money is kept at the home on behalf of the resident. The home has up to date risk assessments for all aspects of health and safety. Staff have received mandatory training in health and safety topics such as moving and handling, fire safety and food hygiene. All the domestic and kitchen staff and some of the care staff have had updates in COSHH training. Throughout the inspection staff were observed to be working using safe working practices. Parkhill Nursing Home DS0000025448.V283833.R01.S.doc Version 5.1 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 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 4 X 3 X X 4 X 4 STAFFING Standard No Score 27 X 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 X X 3 Parkhill Nursing Home DS0000025448.V283833.R01.S.doc Version 5.1 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 15 Requirement The registered person must ensure that care plans set out in detail the actions which need to be taken to ensure that all aspects of the health, personal and social care needs of the residents are met. (Timescale of 31/10/05 not met). The registered person must ensure that nutritional risk assessments are undertaken for all residents. The registered person must ensure that advice and treatment ordered by other healthcare professionals is transferred to the resident’s care plan. The registered person must ensure that on occasions where a variable dose of medication is prescribed, for example, one or two tablets to be taken, an accurate record is made of the actual dosage of each medication administered. The registered person must ensure that an accurate dated record is maintained of all DS0000025448.V283833.R01.S.doc Timescale for action 30/04/06 2 OP8 14 31/05/06 3 OP8 13 30/04/06 4 OP9 13 30/04/06 5 OP9 13, 17 30/04/06 Parkhill Nursing Home Version 5.1 Page 20 6 OP9 13 7 OP31 18 medication received by the home in order to maintain a complete audit trail of medication. The registered person must 30/04/06 ensure that stocks of medication are rotated regularly and that stock is checked each month prior to medication ordering to prevent the build up and wastage of excess medication. The registered person must 31/12/06 ensure that the registered manager undertakes the Registered Managers Award. 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 OP8 Good Practice Recommendations The registered person should ensure that care plans include specific details about the type of pressure mattresses being used and the pump settings if applicable so that staff can ensure they are working properly. The registered person should ensure that medication storage areas are kept clean and tidy. 2 OP9 Parkhill Nursing Home DS0000025448.V283833.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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. 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