Inspection on 16/03/06 for Parklands

This inspection was carried out on 16th 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

Parklands 24/01/08

Parklands 21/02/07

Parklands 18/11/05

Parklands 04/02/05

Parklands 23/09/04

Parklands 16/03/04

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Maple Lodge

Heathlands

Aston Court Nursing Home

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Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Parklands Callow Hill Lane Callow Hill Redditch Worcestershire B97 5PU Lead Inspector Y South Unannounced Inspection 16th March 2006 11.20 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 DS0000033906.V286416.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. Parklands DS0000033906.V286416.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Parklands Address Callow Hill Lane Callow Hill Redditch Worcestershire B97 5PU 01527 544581 01527 544393 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) Dr Steven Sadhra Mrs Margaret Phillips Care Home 31 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (13), of places Physical disability over 65 years of age (12) Parklands DS0000033906.V286416.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th November 2005 Brief Description of the Service: Parklands is a large, detached property situated in a secluded, rural setting on the outskirts of Redditch overlooking the Worcestershire countryside. The property stands in several acres of ground surrounded by lawns and woodlands. There are car-parking facilities at the front of the premises. The house has been adapted for its current purpose as a residential care home The residents are accommodated on the ground, first and second floor of the premises in 7 double bedrooms and 17 single bedrooms. Five of the 7 double bedrooms have an en suite facility. The home has a passenger lift to assist the service users to gain access to the accommodation above ground floor level. Communal lounges, dining facilities, bathroom and toilet facilities are also provided. A personal care service is provided for a maximum of 31 older people i.e. people above the age of 65 years. Within the total number the home may accommodate 12 older people with a physical disability and 6 older people with a dementia illness. The home’s main aim is to provide a high standard of care for elderly people based on individual needs in a homely and comfortable atmosphere while endeavouring to ensure that the residents retain their self-respect, individuality, privacy and independence. The home has been operating under the present proprietorship, Dr Steven Sadhra for the past four years and the registered manager Mrs Margaret Phillips has been in post for more than twenty years. Parklands DS0000033906.V286416.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced inspection took place over approximately four and a half hours and focused on the requirements and recommendations that arose out of the previous inspection and key standards that have not been assessed this inspection year. Mrs Phillips the manager and Ms Kirsty Street a senior care assistant assisted the inspector. A partial tour of the home was undertaken and the inspector spoke to residents in the lounge and one person in their bedroom. What the service does well: What has improved since the last inspection? Following the previous inspection the home was asked to address twenty-one tasks. Sixteen of these have been successfully achieved and work is in progress on the remainder. Information for prospective residents has been updated, care records have been improved. Areas of the environment have also been improved and some aspects of health and safety addressed. Parklands DS0000033906.V286416.R01.S.doc Version 5.1 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 DS0000033906.V286416.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 Parklands DS0000033906.V286416.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): EVIDENCE: These standards were not assessed in full. However requirements and a recommendation made following the previous inspection were assessed as met. An acceptable statement of purpose and service users’ guide were available. Copies of the service users’ guide had been given to all current residents and were available for new people. Parklands DS0000033906.V286416.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): 8, 9 The health care needs of residents are addressed well and medication is managed with due regard for health and safety. EVIDENCE: It was required following the previous inspection that the residents’ care plans must set out in detail the action which needed to be taken by care staff to ensure that all aspects of the health, personal and social care needs of the service users were met and a risk assessment be carried out and recorded in respect of all the service users who were at risk of falling. It was recommended that this be done within the timescale set by the manager and a key worker system be developed. Work was well in hand to complete the programme of care plan development and the inspection temporarily interrupted this task. An example had been well developed and provided detailed information for staff relating to the care of the individual. Risk assessments were also available. The key worker system had been implemented and was developing satisfactorily. Parklands DS0000033906.V286416.R01.S.doc Version 5.1 Page 10 Records and observation confirmed that health care was being monitored and concerns were being identified and addressed. Advice and assistance from other health care professionals was being sought and obtained when necessary. One ill resident was receiving all necessary care and support and looked most comfortable. Residents confirmed that they were happy and well looked after. Medication storage and security was acceptable. None of the current residents wished to self medicate. However the manager confirmed that risk assessments were carried out when this was required. Medication records were well maintained. However hand written additions and amendments to Medication Administration Sheets (MAR) must be signed by two staff to ensure accuracy. The Boots modular dosage system was in use and staff had received training to use this. All except one of the staff authorised to administer medication had recently received additional medication training. Parklands DS0000033906.V286416.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): EVIDENCE: These standards were not assessed in full. However compliance with the requirements and recommendation set in the previous report was checked. These were that a risk assessment be carried out and recorded in respect of all service users who were at risk of choking, the process of carrying out a nutritional assessment in respect of all the service users be completed and a daily record of the social/leisure programme of activities arranged or provided by or on behalf of the home should be maintained. None of the current residents demonstrated any risk of choking so this requirement was no longer applicable. The manager confirmed that such risk assessments would be undertaken should the need arise. Work was in progress on the nutritional assessments and would be completed within the time scale set in the inspection report. The cook demonstrated that clear records were maintained and the needs of individuals were addressed. Residents were most complimentary regarding the food they were served. Records demonstrated that activities and stimulation was provided. Parklands DS0000033906.V286416.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): EVIDENCE: These standards were not assessed during this inspection. Parklands DS0000033906.V286416.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): 26 Residents live in a pleasant, safe environment that suits their wishes and needs. Measures are in place, which reduce the risks of cross infection. EVIDENCE: Seven requirements and recommendations were made in the previous report relating to these standards. Six had been met and the seventh was being addressed. An audit had been conducted of all of items of furniture provided in residents’ bedrooms. An action plan had been drawn up and was being implemented with purchases being made to ensure the standard be met. Although the time scale set in the report had not been met the manager expected to complete the plan/programme within the next three months and undertook to inform the Commission for Social Care Inspection when this had been achieved. Parklands DS0000033906.V286416.R01.S.doc Version 5.1 Page 14 Door locks, that met the recommended specification agreed with the Hereford and Worcester fire authority, had been purchased. Although the timescales had not been met fitting was due to commence on Monday of the coming week and the Commission for Social Care Inspection will be informed when the work is complete. The carpet in bedroom 20 had been replaced and the staff call system in bedroom 7 had been repaired. The manager confirmed that the temperature of the hot water in all of the service users’ bedrooms and in all of the hot water outlets used by residents had been tested and regulated where necessary, and maintained at 43 degrees C in order to prevent the risk of scalding. The manager said that all thermostatically controlled mixer valves would be reviewed again by a qualified plumber next week. Adjustments and replacements will then be made as necessary. Valves had been fitted to all of the hot water outlets used by residents. An assessment had not yet been carried out by an occupational therapist for service users with sensory impairments. There was some discussion as to how this could be achieved. A partial tour of the home was undertaken and it was observed to be clean and free from unpleasant odours. Appropriate infection control policies and procedures were available for staff to consult and measures were in place. Staff training had been completed by eighteen of the staff team. It was recommended that one of the sinks in the laundry should be identified by a notice instructing that it was to be used for hand washing only, and the floor would be easier to clean if the tiling extended over the whole area. Parklands DS0000033906.V286416.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, 30 Residents are cared for by a stable staff team that receive training to develop their knowledge and skills enabling them to deliver a good standard of care. EVIDENCE: Arrangements had been made for staff to receive training that will enable a minimum of 50 of the care staff to attain a qualification at NVQ level 2 or equivalent by December 2006. The home had a total care team of fifteen persons of whom six had qualified to NVQ level 2 and one person was currently on the course. Discussions took place on the day of this inspection with Bromsgrove College for more staff to be enrolled on courses and it was expected that they would commence their studies in September. The home was using the Worcester Induction Training Manual for new staff. Individual training records were maintained. The training matrix for the staff team was not available however a booking sheet was seen for a range of courses in core care subjects. Parklands DS0000033906.V286416.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): 35, 38 Resident’s financial matters are well managed on their behalf. The home operates with due attention to the health and safety of those who are in it. However risks could be reduced further by increasing staff training in first aid, food hygiene and fire safety. EVIDENCE: Since the previous inspection the registered manager had achieved a qualification in the Registered Managers’ award. Requirements were made that the registered manager must undertake training in first aid at work and in risk assessment. These have yet to be achieved as the manager was concentrating on completing the RMA course she was undertaking. Parklands DS0000033906.V286416.R01.S.doc Version 5.1 Page 17 A requirement that a quality assurance system must be introduced in accordance with the requirements of Regulation 24 and Standard 33. (Previous timescale of 28/02/05 not met) was still outstanding. Distribution of questionnaires was in progress and audits of various systems were routinely undertaken but information from all elements needed to be drawn together to enable a quality assurance programme to be formed. Residents’ personal monies were being appropriately stored and managed. Good records of income and expenditure were being maintained but receipts should be given for all monies left with the home for residents. A health and safety policy and procedure was available for staff to consult. Training was provided in health and safety subjects. However although six staff were trained in emergency aid and no one was a qualified first aider. A qualified first aider is someone who has a current qualification in the fourday First Aid at Work course. It is required that such a person is on duty at all times. It was recommended that this could best be achieved by ensuring all persons left in charge of the home (day and night) are so qualified. Training in food hygiene needed to be up dated and fire safety training needed to be increased. All staff must update their fire safety training every three months and participate in at least one drill in a year. This must be closely monitored and individual training records be maintained to ensure full training of the staff team. Equipment was being appropriately serviced and maintained and two risk assessments were seen for identified hazards. Parklands DS0000033906.V286416.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 3 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X 2 X 2 3 2 STAFFING Standard No Score 27 X 28 2 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 2 X X 2 Parklands DS0000033906.V286416.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 programme of care plan development must be completed. All hand written additions and amendments to residents’ MAR sheets must be signed by two staff. The registered manager must undertake training in first aid at work and in risk assessment. A trained first aider (some one who holds a qualification in the four-day First Aid at Work course) should be on duty in the home at all times. Staff must receive food hygiene training updates. Timescale for action 31/03/06 2 OP9 17 16/03/06 3 OP31 9,18 30/06/06 4 OP38 OP30 18, 13 30/06/06 5 OP38 OP30 18, 13 30/08/06 Parklands DS0000033906.V286416.R01.S.doc Version 5.1 Page 20 6 OP38 OP30 18, 23 All staff must receive fire safety training every three months and participate in at least one fire drill every year. Participation must be closely monitored and recorded. A quality assurance system must be introduced in accordance with the requirements of Regulation 24 and Standard 33. (Previous timescale of 28/02/05 not met). Receipts must be given for all monies accepted to be managed for residents. 31/03/06 7 OP33 24 31/03/06 8 OP35 17 16/03/06 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 OP22 Good Practice Recommendations An assessment should be carried out as necessary by an occupational therapist for service users with sensory impairments. The hand sink in the laundry should be identified by a suitable notice, and consideration be given to extending the floor tiles to cover the entire floor. 2 OP26 Parklands DS0000033906.V286416.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Parklands DS0000033906.V286416.R01.S.doc Version 5.1 Page 22 - 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. 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