CARE HOMES FOR OLDER PEOPLE
Parklands Parklands Highfields New Road Crook Durham DL15 8PU Lead Inspector
Bridgit Stockton Unannounced Inspection 18th October 2005 10:30 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 DS0000007496.V258726.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 DS0000007496.V258726.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Parklands Address Parklands Highfields New Road Crook Durham DL15 8PU 01388 762925 01388 762925 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) Mr Tarsem Lal Chopra Lisa Zoe Foster Care Home 36 Category(ies) of Dementia (1), Learning disability (3), Old age, registration, with number not falling within any other category (32) of places Parklands DS0000007496.V258726.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 19th October 2004 Brief Description of the Service: Parklands Residential Care Home provides residential care services For up to thirty six older people who require personal care. The home is situated in a quiet part of Crook and is conveniently located for access to all local amenities. The home is a two-storey building that is serviced by a passenger lift. There is ample car parking space located at the front of the home and the gardens are safe and well kept. Parklands DS0000007496.V258726.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was carried out over a period of 3 hours on 19th October 2005. The plan for the inspection was to check whether the home had met previous requirements and recommendations; to talk with service users about living in the home; to meet with care and kitchen staff and the home’s management team; and to look at records. What the service does well: What has improved since the last inspection?
Staff training has progressed well with over half of the staff having completed a certificated course in caring for people. It is planned that the rest of the staff team will also obtain this certificated training. The manager has been in post almost a year and improvements have been made in the management of the home, such as staff supervision, appraisal and the setting up of staff records.
Parklands DS0000007496.V258726.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 DS0000007496.V258726.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 DS0000007496.V258726.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): 3 Assessments of all new residents takes place prior to them living at Parklands. This is to ensure that individual care needs can be met within the service. EVIDENCE: The assessment documentation and recording of a new resident was good and in sufficient detail so as to make it possible for the care needs to be identified and from which a care plan has been developed. The manager confirmed that she visits all new residents prior to admission, and takes into consideration the equipment they require and the dependency of the other residents living at the home and the bedroom available with regard to location and size of room. The staff spoken to explained how they were able to meet the needs of the residents and spoke with individual knowledge of particular residents. Parklands DS0000007496.V258726.R01.S.doc Version 5.0 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): 7,8,10. Whilst all service users have a plan of care, more specific details are required to ensure that each resident needs are met fully. Service users can expect their privacy and dignity to be maintained. EVIDENCE: All of the care plans looked at contained a considerable amount of information and staff were recording and evaluating the plans on a regular basis. However it was felt that some of the specific details that are handed over verbally between staff at the change over of shift could be recorded formally. For example one of the plans stated that a resident was incontinent, and used incontinence pads, the detail as to what type of pads required or if the service user needed assistance with this element of there care was not recorded. The recording of risk assessments was good and was included in the care plans. There was also evidence of involvement from external heath care professionals such as the district nurse, optician and chiropodist. Staff were observed caring out support and care for residents discreetly. Resident’s dignity was upheld. Parklands DS0000007496.V258726.R01.S.doc Version 5.0 Page 10 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): 12,13&14 Flexible visiting arrangements allow the residents to maintain good and regular contact with family and friends. Residents living at the home are supported to have choice and control over how they choose to live. EVIDENCE: Residents confirmed that they could have as many visitors as they like and at any time they chose. The visitors are made to feel welcome during their visits and there were several visitors coming and going during the inspection. People spoken to follow their own hobbies and participate in activities outside of the home according to their wishes. Several residents said that because the shops were in close proximity to the home they enjoyed going to town especially on market day. Residents said they also enjoy dominos, bingo and musical entertainment, they said that there was nearly always some organised activity daily and they could choose to attend if they wanted to participate. Parklands DS0000007496.V258726.R01.S.doc Version 5.0 Page 11 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 Service users can be confidant that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse. EVIDENCE: The complaint record book remains empty. Residents said that if they needed to complain they would talk to the manager, the staff or Mr Chopra the responsible individual. There are adequate written policies and procedures in place to deal with complaints and the care staff spoken to confirm they were aware of these. Staffs knowledge of these help ensure that they were able to address any issues or anxieties of the residents, relatives and visitors to the home. Staff training has taken place in the protection of vulnerable adults in abuse. Staff recruitment procedures were adequate and staff were employed and deployed following appropriate CRB and POVA checks. The manager and staff team were clear and confident in the protection of vulnerable adult procedures. Parklands DS0000007496.V258726.R01.S.doc Version 5.0 Page 12 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&26 Whilst the home was clean and comfortable some of the communal areas are in need of attention EVIDENCE: Residents spoken to said they liked being able to bring into the home small items of furniture along with pictures and photographs to make there own rooms more pleasant and feel more like home. The communal areas of the home were clean and residents confirmed that their bedrooms were also cleaned to a good standard. Some of the communal areas such as the large lounge are looking ‘tired’ the wallpaper that is coming away from the wall needs repair or replacement and the curtains in this room are looking faded. The paintwork in the entrance hall is in need of attention and the light coloured carpet is showing signs of wear particularly at the front door and near to the entrance of the downstairs toilets. Parklands DS0000007496.V258726.R01.S.doc Version 5.0 Page 13 Parklands DS0000007496.V258726.R01.S.doc Version 5.0 Page 14 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): 27,28,29 &30 The recruitment and training of staff is good which contributes to the ongoing safety of service users. EVIDENCE: Residents said that they never felt hurried by staff and that staff were always available to assist them. The duty rota evidenced that sufficient staff are on duty and deployed appropriately in order to meet residents needs. The home had staff files in place, which indicated that the appointment of a new staff member is made through proper recruitment processes. This includes the vetting of staff through the use of references, POVA first checks and Criminal Record Bureau (CRB) checks. There is a commitment at the home to having a trained workforce with over half of the care staff having completed NVQ level two or three training in care. There is a plan for another eight care staff to commence this course. Seven of the care staff have attended a course in dementia training and it is scheduled that the remaining staff team will also complete this training All new staff receive a thorough induction and this was documented in the staff files examined. Parklands DS0000007496.V258726.R01.S.doc Version 5.0 Page 15 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 Residents can be confident that as far as possible there financial interests are protected and safeguarded EVIDENCE: There is in place a policy and procedure for dealing with residents finances. At the inspection the records of service users money was checked and reconciled with the money in the home. All transactions are receipted and documented with two signatures obtained following any transactions. The home deals with very few service users personal allowance. Parklands DS0000007496.V258726.R01.S.doc Version 5.0 Page 16 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 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X X Parklands DS0000007496.V258726.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 OP7 Good Practice Recommendations It is recommended that the manager reviews the care plans of service users, to make sure that they are written in sufficient detail to ensure that all identified needs are being documented in full and met. It is recommended that a program be compiled with timescales for the redecoration/refurbishment of the communal areas in the home. 2 OP19 Parklands DS0000007496.V258726.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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