Inspection on 23/08/05 for Parkhill Nursing Home

This inspection was carried out on 23rd August 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

Parkhill Nursing Home 26/06/07

Parkhill Nursing Home 17/03/06

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 Fiona Bryan Announced 23 August 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 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 F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Parkhill Nursing Home Address 319 Huddersfield Road, Stalybridge, Tameside SK15 3EP 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) 0161 303 8643 0161 338 6910 Belmont Parkhill Limited Mrs Christine Holland Care Home with Nursing 38 Category(ies) of PD(E) - Physical Disability - over 65 - 38 registration, with number OP - Old Age - 38 of places PD - Physical Disability - 10 Parkhill Nursing Home F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 38 PD(E), up to 38 OP and up to 10 PD 2. The registered manager to be supernumerary for 27 hours per week. 3. A minimum of 238 qualified staff hours to be deployed per week. 4. No more than 10 service users to be admitted who are between the ages of 18 and 65 years. Date of last inspection 2nd March 2005 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 a small number of 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 F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was undertaken by one inspector who spent time talking to residents, relatives and staff. Three residents were looked at in detail, looking at their experience of the home from their admission to the present day. A partial tour of the building was conducted and a selection of staff and residents records were examined including records of care, staff duty rotas and training records. Comments cards for residents and visitors were left at the home but none had been returned at the time of writing this report. Prior to the inspection, comments cards were sent to some GP’s who visit the home to see their patients. One GP returned a comments card and was positive, stating they were very satisfied with the overall care provided to residents in the home. What the service does well: Parkhill has a friendly and relaxing atmosphere and staff are welcoming and professional. Regular visitors to the home said that this was their experience of the home. Residents and relatives were very positive about the staff at the home, commenting “the staff are angels”, “nothing is too much trouble” and “I feel safe here”. One resident said she was content and happy at the home and a visitor confirmed that it did not matter at what time of the day she came, staff were always helpful and polite and she had observed them dealing with residents with kindness and respect. The home has lovely grounds and gardens, with colourful flowers, a pond and water features and peaceful seating areas for the residents to enjoy the views. The residents’ rooms are light and airy and each room feels personal and homely. The manager works some shifts alongside the carers and nurses, delivering care, and therefore has close contact with residents and their families. Residents, relatives and staff all said that the manager was approachable and easy to talk to. One resident said there was no bad side to living at the home. Parkhill Nursing Home F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 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 F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Parkhill Nursing Home F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 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 standard(s) 3 and 4 Residents are assessed before coming into the home. Residents and relatives are confident that the home can meet their needs. EVIDENCE: Examination of three care files showed that in all cases individual care plans from social services had been provided. The home had also undertaken its own pre-admission assessments. Relatives are asked to complete social histories and some were detailed, giving a good background for staff to appreciate the resident as an individual. Carers said when a new resident came in to the home they would look at the care plan and at the information provided, and would discuss what care they needed to provide with the nurse in charge. Handovers are given at the start of every shift to make sure staff are aware of any changes to residents’ conditions or the care they need. Parkhill Nursing Home F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 Page 9 The home operates a key worker and named nurse system so residents and relatives have a point of contact and to maximise continuity of care. Efforts are made to meet individual needs, for example one resident likes to sit in a particular corner of the lounge and staff have made sure she has a television within view and photographs of her dog and her possessions around her. Residents said staff knew them well and understood the care they needed and their preferred routines. Parkhill Nursing Home F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 More rigour is needed to ensure that care plans identify and fully address all the residents’ needs, and plans need to be carried out systematically and updated 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. Residents are very satisfied with the way staff treat them. EVIDENCE: Examination of a selection of care files showed some confusing information, for example it stated in one assessment that the resident needed a regime of enteral feeding, however the care plan had been updated to indicate that the resident now only needed bolus feeds, whilst a notice on the wall gave a different regime. Information on the care plan must be up to date. Care plans had not been developed for some residents’ healthcare needs, for example for one resident with MRSA. There was some evidence that actions stated in the care plan were not always carried out in practice, for example it was stated that one resident should have Parkhill Nursing Home F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 Page 11 their fluid intake and output monitored, however the chart was not completed properly. There was no evidence that care plans had been discussed with residents or their representatives, although they said they were kept informed about any changes to their condition or care. Residents said staff made sure they were seen by their GP if necessary and attended hospital appointments. Records also showed that residents had been seen by opticians and chiropodists. Examination of medicine administration records showed that one medication for one resident had not been administered as prescribed. New procedures were discussed for the disposal of medicines and satisfactory arrangements had been made by the home. Specimen signatures were provided. Oxygen cylinders were stored in the treatment room and appropriate safety signage was displayed. Residents were very complimentary about the staff, saying that they were treated very well, with kindness and respect. Staff were observed to be friendly and professional and two visitors said that the atmosphere in the home and the attitude of staff was always the same regardless of when they visited. Parkhill Nursing Home F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15 The lifestyle needs and choices of the residents are met. Visitors are encouraged and welcomed in to the home. Meals are generally satisfactory but the new arrangement of meal times needs careful monitoring to ensure it is suitable for the residents. EVIDENCE: Residents stated that they were free to move around the home as they wished and could choose how to spend their day. The home’s administrator is allocated some hours per week to organise activities and holds a singalong afternoon each Friday. Residents also said that they took part in chair aerobics every Wednesday and an aromatherapist visits the home each week (residents pay extra for this service). One visitor said staff had arranged a birthday party for the resident she visits and a barbeque was held over the summer. One resident said he would like to go out more and staff said they would like to be able to take residents out more frequently. This was discussed with the manager who agreed to consider how this could be arranged. Parkhill Nursing Home F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 Page 13 Staff try to meet individual interests, for example one resident enjoys knitting and had been provided with wool and needles and also crayons and pencils for art work. A minister from the local church visits some residents and members of the congregation visit every fortnight to chat with residents. Visitors commented that they were always made to feel welcome and could visit at any time. Mixed comments were received about the food. One resident said the food was excellent, another said it was sometimes alright, but they accepted that it was “difficult to please everyone all the time”. Residents had been consulted and mealtimes changed round so that the main meal of day is now served at teatime and a lighter meal is served at lunch, as a lot of food was being wasted previously as residents weren’t hungry. One resident complained that a buffet was served at lunch on the Sunday before the inspection and a cold buffet was also going to be served at teatime until some of the residents and staff complained. Some of the care staff made a hot meal but proper arrangements must be made to ensure that a hot meal is offered at least once a day. Lunch on the day of the inspection was chicken nuggets and chips or assorted sandwiches. The menu for tea offered sliced meat, potatoes and vegetables. A cooked breakfast is offered at weekends although residents can have egg on toast any morning if requested. One visitor said kitchen staff came round each day to discuss the menu with residents and were always very obliging and happy to arrange alternatives. Parkhill Nursing Home F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 Page 14 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 standard(s) 16 and 18 Residents and relatives are confident that any complaints will be dealt with satisfactorily. Further training is required to ensure that residents are protected from abuse. EVIDENCE: The complaints procedure is displayed in the reception area of the home and the manager stated that a copy is given to residents or their representatives on admission to the home. Residents and relatives said they would bring any concerns to the attention of the manager and were confident that they would be dealt with properly. A record of complaints is kept. Two minor complaints were on record, which had been dealt with satisfactorily. Some staff had undertaken some training in the prevention of abuse as part of their NVQ training. However, other staff have not yet received training in this topic or in dealing with challenging behaviour. Staff said they would report any suspicion of abuse but one nurse was unaware of the Tameside local procedures. Parkhill Nursing Home F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 Page 15 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 standard(s) 19, 20, 21,24 and 26 The home is well maintained, clean, safe and pleasant for residents to live in. Appropriate toilet and bathroom facilities are provided. EVIDENCE: A partial tour of the home provided evidence of an ongoing maintenance and refurbishment programme. The furniture in all the lounges has been replaced and new curtains have been purchased. The manager reported that new furniture for the bedrooms had been ordered and was due to be delivered in September 2005. On the middle floor one bath has been replaced with a disabled shower which staff say is much better for residents and easier for them to use. Parkhill Nursing Home F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 Page 16 The home has delightful external grounds with lots of bedding plants in baskets and tubs, a lovely garden area looking over the surrounding countryside and a water feature and small pond. Garden furniture is placed at different points in the grounds allowing residents to sit and enjoy the views. Residents said they were very happy with their rooms, which were seen to be spacious, homely and comfortable. Residents had been encouraged to bring personal possessions into the home with them, including pictures, photographs ornaments and small items of furniture. Profiling beds have been provided for some residents. Parkhill Nursing Home F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 There are usually enough staff on duty to meet the needs of the residents. Training on a variety of topics has been provided, but staff need further training in some areas. EVIDENCE: Although residents felt there were usually enough staff on duty to meet their needs, staff said they needed to increase staffing levels as they have recently had several new admissions. The manager reported that recruitment of new staff was underway and in the meantime if necessary agency staff have been employed. Training records showed that some staff had undertaken a one day study day in dementia care, and had received training in gastrostomy care, wound care, catheterisation and had had updates in health and safety practices. Fire training had been arranged for September 2005. Dietary training had been provided for the kitchen staff and the carers. It was reported that first aid training was being accessed. As stated elsewhere in this report, training in dealing with challenging behaviour is needed. Parkhill Nursing Home F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 Residents are consulted about how the home is run. EVIDENCE: The manager makes efforts to ascertain the views of residents and relatives but has not always had good responses to satisfaction questionnaires and is therefore considering other quality assurance and monitoring measures. A residents meeting was last held in March 2005 and minutes were displayed. The manager regularly works with the carers and nurses delivering care and as such is visible around the home. Residents, relatives and staff said the manager was very approachable. The manager has meetings with the nurses who then meet with senior carers to cascade information. Staff said meetings provided the opportunity for twoParkhill Nursing Home F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 Page 19 way communication and they were able to suggest changes, for example to their working routines that may be beneficial to residents. The registered person must ensure that reports of visits to the home are supplied to the CSCI. Parkhill Nursing Home F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x 2 x x x x x Parkhill Nursing Home F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 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 7, 8 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 and must ensure that the care stated is carried out as planned. The registered person must ensure that residents receive the medicines prescribed for them. The registered person must ensure that staff receive training in prevention of abuse and dealing with challenging behaviour. The registered person must ensure that reports of their visits to the home are supplied to the CSCI. Timescale for action 31/10/05 2. 3. 9 18, 30 13 13, 18 15/10/05 31/1/06 4. 33 26 31/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 Page 22 Parkhill Nursing Home 1. 7 2. 15 The registered person should ensure that if residents lack capacity for involvement in the development of their care plan, this is documented and their representative should sign agreement of the care plan on their behalf if possible. The registered person should ensure that the new arrangements for menus and mealtimes is reviewed to ensure the continued satisfaction of residents. Parkhill Nursing Home F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 2nd Floor, Heritage Wharf Portland Place Ashton-under-Lyne 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. Extracts may not be used or reproduced without the express permission of CSCI Parkhill Nursing Home F54 - F04 s25448 Parkhill v239121 230805 Stage 4.doc Version 1.40 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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