CARE HOMES FOR OLDER PEOPLE
Parklands Station Road Rawcliffe Goole East Yorkshire DN14 8QP Lead Inspector
Ms Wilma Crawford Unannounced Inspection 10th January 2006 09:30 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 Parklands DS0000019705.V271351.R01.S.doc Version 5.0 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. Parklands DS0000019705.V271351.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Parklands Address Station Road Rawcliffe Goole East Yorkshire DN14 8QP 01405 839226 01405 839699 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) Humberside Independent Care Association Limited Mrs Caron Lesley Rogers Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (30) of places Parklands DS0000019705.V271351.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 8th September 2005 Brief Description of the Service: Parklands is situated in the rural village of Rawcliffe near to the port of Goole in East Yorkshire. The home is owned and operated by Humberside Independent Care Association Ltd. (HICA) which is a not for profit organisation.The home provides personal care and accommodation for up to 30 older people, some of whom may have a dementia care need. Accommodation is provided on two levels with a passenger lift allowing access to the first floor. All rooms are for single occupancy with four of the rooms having a private sitting area. Two of the rooms are en suite. Service users have ample communal including a conservatory in which they can relax. Air conditioning is provided for service users’ comfort. Parklands DS0000019705.V271351.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over 6 hours. A tour of the premises was conducted with the care manager in the absence of the homes manager.The main method of inspection used was called case tracking which involved selecting four residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. Three care staff and a relative were also spoken with. What the service does well: What has improved since the last inspection?
Since the last inspection recording practices for complaints has been improved. Details of all complaints and the action taken to resolve them, is available. Complaints are also dealt with promptly. The sluice and laundry areas have been redecorated and signs are in place to remind staff that the sluice hoppers need to be flushed after use. Staff spoken with, had a good understanding of infection control and were aware of their role in maintaining a clean and safe environment.
Parklands DS0000019705.V271351.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Parklands DS0000019705.V271351.R01.S.doc Version 5.0 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 Parklands DS0000019705.V271351.R01.S.doc Version 5.0 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): 1,2,4,5, Residents are given the opportunity to visit the home before making a decision to move in. They can feel confident that their assessed needs will be met. The Statement of Purpose and Service User guide need do not provide current information. EVIDENCE: The home has an admission policy and procedure, which includes an assessment being carried out prior to admission, this is undertaken to make sure that the home can meet prospective residents needs. This is confirmed in writing. All residents enter into a ‘contract’ with the home and a signed copy of this is held in a locked filing cabinet. Residents’ care plans showed that a needs assessment is completed for all residents. This is carried out prior to admission if possible and if not as soon as possible afterwards. For residents admitted under the care management approach this is in addition to that assessment. Three residents spoken with confirmed that this had taken place and they were able to visit the home before making a decision to move in.
Parklands DS0000019705.V271351.R01.S.doc Version 5.0 Page 9 The needs assessment addresses all activities of daily living and strengths and needs of residents. There is evidence within the assessment that residents and their families are involved at this stage. Parklands DS0000019705.V271351.R01.S.doc Version 5.0 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 the following standard(s): 7,11 The home’s records overall, give a clear picture of the needs of the residents and enable staff to meet their needs with sensitivity and regard for their privacy and dignity. EVIDENCE: Four residents were selected for the ‘case tracking’; their care plans were informative as to what was required to meet each resident’s needs, including risk assessments for moving and handling. Individual keyworkers are responsible for ensuring that care plans were updated regularly. However one resident who had previously been at the home for day care had not had their care plan updated to reflect that they were now living in the home on a more permanent basis. The privacy and dignity of residents was observed throughout the inspection, with staff members treating residents with courtesy and friendliness and knocking on room doors before entering. Residents said “the staff are good kind and helpful.” “The staff are very helpful and nice.”
Parklands DS0000019705.V271351.R01.S.doc Version 5.0 Page 11 Residents’ wishes in the event of their death were not recorded for all residents. Care plans should contain this information about what they and their families want to happen in the event of their death. Parklands DS0000019705.V271351.R01.S.doc Version 5.0 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 the following standard(s): 12 Only limited activities are available within the home. EVIDENCE: A recommendation was made at the previous inspection requesting that the home consider employing a dedicated activities coordinator, to enable activities be arranged on a more frequent and regular basis. This is still being considered. During discussion with staff, residents and relatives it was apparent that the staff do their best to enable activities, but due to the change in residents needs, the majority of their time is spent in the delivery of care. Three monthly dinner dances continue to be organised, a hairdresser visits regularly and a Christmas party had been enjoyed by residents. However all residents, relatives and staff spoken with stated that they would like to see more, organised and planned activities in the home. Parklands DS0000019705.V271351.R01.S.doc Version 5.0 Page 13 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): 16,18 Residents are protected by procedures in place for handling complaints and allegations of abuse. EVIDENCE: HICA have a comprehensive complaints procedure. The complaints procedure is included in the information pack that is sent out to prospective residents but staff also confirmed that the procedure is explained to residents on an ongoing basis and records of house meetings indicated that residents are given opportunities to raise any issues that they may be unhappy about. Three residents spoken to also confirmed that they felt able to talk over any concerns or problems with staff. One complaint had been by the home since the last inspection. This had been resolved to the complainants satisfaction and details of the complaint were recorded in the complaint log. There is a satisfactory adult protection procedure in place and an up-to-date copy of the Local Authority Adult Protection procedure was available. Staff comments indicated they were aware of correct reporting procedures. Residents commented positively about the care and support they received from staff and felt able to talk over problems with them. Parklands DS0000019705.V271351.R01.S.doc Version 5.0 Page 14 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): 19,22,23,24,25,26 The residents live in a comfortable, pleasant and safe environment, with both private and communal space being generally suitable for their needs. EVIDENCE: A tour of the premises showed that the home was maintained to a good standard internally, was tidy, clean and free from odour. The grounds and gardens were well-tended with an enclosed court yard and safe lawned garden. The home employs housekeepers who provide cleaning duties within the home. There are four large bathrooms, one with an assisted bath,5 toilets and two rooms with en suite facilities. Specialist equipment is available throughout the home, including a lift, stair lifts, assisted bath, raised toilet seats, grab rails and a call bell system. Parklands DS0000019705.V271351.R01.S.doc Version 5.0 Page 15 Residents’ comments were positive about their bedrooms and each room viewed was individually decorated and furnished and contained personal items reflecting individual interests and tastes. Parklands DS0000019705.V271351.R01.S.doc Version 5.0 Page 16 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): 27,28,30 Staff numbers are in sufficient quantity for them to be able to care for the residents, but not always at busy times. Staff members are suitably trained, qualified and competent. EVIDENCE: Staff and residents spoken with felt that there were occasions where they would benefit from having some extra help, particularly at busy times, mealtimes and in the evening. Residents spoken with felt that the staff did their best but were not always able to support them at the time they wanted. , Residents gave examples of having to wait to go to bed, later than they preferred, and another gave an example of having to wait upstairs in a corridor to see the hairdresser as staff would not be available later to take them up. Residents were positive about the care they received; one said, “the staff are all very kind”. Another said “ the staff are all very nice and helpful” Staff interviewed said they had given two references, which were followed up, a CRB check and undertaken an induction programme prior to commencing work. Staff records seen verified this. Training records showed that 8 care staff had achieved the National Vocational Qualification at Level 2, and a further two staff are working towards level 2. The training plan showed that all statutory training was being undertaken, with the most recent training being on First aid, Food hygiene, Health and Safety, Dementia, Caring for the dying and fire training.
Parklands DS0000019705.V271351.R01.S.doc Version 5.0 Page 17 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): 35,36,37 Staff are well supported and supervised in carrying out their respective roles. To ensure that residents’ financial interests and health and welfare continue to be promoted the requirements in this report must be addressed. EVIDENCE: The minutes from the recent residents’ meeting show that residents do contribute and raise issues, and that action is taken to address these.The home conducts regular surveys to monitor quality and the results have been very positive. The staff team are regularly supervised both formally and during every day observation. Records of these are maintained. Staff confirmed that this takes place during discussion. Annual appraisals also take place. A previous requirement made in respect of residents’ finances at the last inspection had not been fully actioned. The home holds personal monies for a
Parklands DS0000019705.V271351.R01.S.doc Version 5.0 Page 18 number of residents. The monies are held in a bank account under the umbrella of ‘Parklands Resident Account’. Computer records in the home are able to show how much each resident has in the account. The home is able to produce individual accounts for each service user. During the inspection two service users were found to be in a debit balance that effectively means other residents are subsidising this account. This practice is unacceptable and must stop. If difficulties are encountered obtaining personal allowances for residents then the matter must be referred to social services. The manager must continue to make efforts to assist service users to manage their financial affairs independently when possible and encourage them to have their own bank account. Parklands DS0000019705.V271351.R01.S.doc Version 5.0 Page 19 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 2 3 X 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 3 3 3 3 STAFFING Standard No Score 27 2 28 4 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 2 3 2 X Parklands DS0000019705.V271351.R01.S.doc Version 5.0 Page 20 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 OP27 Regulation 18(1(a)) Requirement Timescale for action 31/03/06 2. OP35 13(6) 3. OP12 16(2)m,n 3.
Parklands OP7 14 (2) a The registered person must demonstrate to the Commission in writing how staffing numbers are reviewed, to ensure that adequate staff are available at busier periods, to give residents prompt assistance. Extension to previous timescales agreed. 31/03/06 The registered person must demonstrate to the Commission in writing, the action they intend to take to ensure: no residents accounts fall into a negative balance. If problems arise obtaining personal allowances for residents then a referral must be made to social services and a record of this maintained. Extension to previous timescales agreed. The registered person must 31/03/06 demonstrate to the Commission in writing, the action that they intend to take in order to provide a regular programme of activities available within the home. The registered person shall 31/03/06
DS0000019705.V271351.R01.S.doc Version 5.0 Page 21 4. OP37OP1 17(3)a ensure that the assessment of the service users needs is kept under review : and revised at any time when it is necessary to do so having regard to any change of circumstances.Any changes should also be reflected in the individuals care plan. The registered person shall ensure that the Statement of Purpose and Service Users are kept up to date. Newly admitted service users had copies of these documents which contained information that was no longer current. 31/03/06 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 OP11 Good Practice Recommendations The registered manager should ensure that service user records should contain information about what they and their families want to happen in the event of their death. Parklands DS0000019705.V271351.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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