CARE HOMES FOR OLDER PEOPLE
Parklands Parklands Highfields New Road Crook Durham DL15 8PU Lead Inspector
Bridgit Stockton Unannounced Inspection 6th September 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Parklands DS0000007496.V309200.R01.S.doc Version 5.2 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.V309200.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Parklands Address Parklands Highfields New Road Crook Durham DL15 8PU 01388 762925 P/F 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 (12), Learning disability (3), Old age, registration, with number not falling within any other category (32) of places Parklands DS0000007496.V309200.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Named Individual: The home may accommodate a named individual as set our in a letter to the registered person dated 1 February 2006 which establishes the basis on which the individual’s needs will be met by the home. Where necessary the home’s Statement of Purpose shall reflect any changes in service provision required for this arrangement. This condition may not apply to anyone else, other than the named individual, who falls outside the registered category. 27th February 2006 Date of last inspection 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. Currently the scale of fees charged at the home is £364.50 - £375.00. Parklands DS0000007496.V309200.R01.S.doc Version 5.2 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 the 6th September 2006. The home did not know the inspection was going to take place. The plan for the inspection was to check whether the home had implemented the recommendations made at the previous inspection; to talk with the residents about living in the home; to meet with care staff and the home’s management team; and to look at records. What the service does well: What has improved since the last inspection?
Since the last inspection the home has changed the way in which residents medication is stored, medication trolleys have been purchased and a new medication fridge has been ordered to allow the correct storage of residents medication that requires refrigeration. The redecoration of the lounge area is complete and several bedrooms have also been decorated. There are plans in place over the next few weeks to improve the grounds of the home by supplying seating for residents and some general outside maintenance to be undertaken. Parklands DS0000007496.V309200.R01.S.doc Version 5.2 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.V309200.R01.S.doc Version 5.2 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.V309200.R01.S.doc Version 5.2 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): 1,2,3, &6 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service Prospective service users can be assured that their needs are appropriately assessed prior to admission to the home and that they are given sufficient information to make an informed choice before moving into the home. EVIDENCE: The home’s Statement of Purpose and Service User Guide have been updated to include the new category of registration, allowing the home to admit up to 10 service users who have dementia care needs. These guides contained all of the information that is required to enable people to make an informed choice about where to live. Evidence was seen in service users files that a contract had been signed by service users or their representatives. The contracts need review to include a breakdown of the fees and who was responsible for paying the fee.
Parklands DS0000007496.V309200.R01.S.doc Version 5.2 Page 9 The manager confirmed that visits to prospective service users always take place before their admission to the home, to carry out an assessment of needs. Four service users files inspected had pre admission assessments and care management assessments so that a decision could be made about whether the home was able to meet the needs of the individual. Intermediate care is not offered at Parklands Care Home therefore this standard was not assessed. Parklands DS0000007496.V309200.R01.S.doc Version 5.2 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): 7,8,9 &10 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service Good systems are in place to ensure that health care needs of the service users are met. Service users can be confident that their privacy and dignity is protected and that they are treated with respect. EVIDENCE: A service user plan has been developed for each service user that identifies needs associated with health and personal care. This ensures that staff are clear about what is required of them in meeting a service user’s needs. The care plans of four residents were inspected they were comprehensive and well written. Careful and thoughtful strategies to address particular needs or problems of some service users were well documented and sensitively written. There was evidence of involvement of specialist healthcare people such as the district nurse, the dietician, continence nurse and chiropodist. The medication at the home was inspected. The home operates a monitored dose system. All of the medication was signed for on the medication
Parklands DS0000007496.V309200.R01.S.doc Version 5.2 Page 11 administration record. Two new trolleys for storing medication have been purchased. In addition a new fridge for storing medication that requires refrigeration is also on order. The residents spoken to felt that the staff “were wonderful” and that their particular needs and wishes were addressed in a kind and professional manner. Residents confirmed that their privacy is maintained and respected by staff. Parklands DS0000007496.V309200.R01.S.doc Version 5.2 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): 12,13,14, &15 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The recreational and social needs of service users are well catered for which enables service users to make daily choices and promotes independence. EVIDENCE: There was good practice relating to the promotion of independence and social contact with people outside the home. Service users said that they are able to see their relatives and friends and this was also observed. There was a varied range of activities offered. Some residents had made jewellery and table decorations. During the inspection some service users were enjoying playing dominos. Service users were able choose whether or not they wish to be involved. One service users said she had really enjoyed a singer who had been entertaining in the home. Another service user was taking advantage of the good weather and walking into the nearby town centre. Residents said they ‘loved’ the food provided by the home and were very complementary about the cooks. There was a well balanced menu for service users to choose from, with the daily choices displayed on each dining table.
Parklands DS0000007496.V309200.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users can be confident that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse. EVIDENCE: There are adequate written policies and procedures in place to deal with complaints and the care staff spoken to confirmed they were aware of these. Staffs knowledge of this 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.V309200.R01.S.doc Version 5.2 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 &26 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Whilst the home was clean and comfortable some of the communal areas are in need of attention. EVIDENCE: Some of the carpets in the communal areas of the home require either cleaning or replacing, the recently decorated lounge is spoilt because the carpet is heavily stained, in addition some of the communal chairs are looking shabby and in need of replacement. As yet the hall carpet has not been replaced and this was identified at the previous inspection. The manager and provider are required to review the decoration and furniture in the home and together formulate an action plan with time scales as to when this refurbishment and replacement will take place. Parklands DS0000007496.V309200.R01.S.doc Version 5.2 Page 15 On a more positive note, the residents said they really liked the new wallpaper and curtains in the large lounge There were no outstanding requirements from the fire and rescue service visit or from environmental health inspection. Parklands DS0000007496.V309200.R01.S.doc Version 5.2 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): 27,28,29, &30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The recruitment and training of staff is very good which contributes to the ongoing safety of service users. EVIDENCE: The home had staff files in place that provided evidence 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 50 of care staff having completed NVQ level two or three training in care, a further six other members of staff are also completing this at the end of September. Staff said they found the training helpful in improving their day-to-day practice. A relative spoken with during the inspection said that things would be improved if more staff were on duty. However residents spoken with said that there was ‘always enough staff about’, another one said ‘ the staff are always around and if I use my buzzer it never takes long before it’s answered’. The duty rota was examined it showed that staff were employed and deployed in sufficient numbers to meet the needs of the residents. One member of staff said that they thought they were ‘pretty well off’ for care staff and the only
Parklands DS0000007496.V309200.R01.S.doc Version 5.2 Page 17 time that may have to work short staffed is for unexpected sickness or if a resident needs an escort to hospital. Despite some extra staff hours being utilised to assist the cook in cleaning schedules for the kitchen it still isn’t enough. The cook felt that there were outstanding cleaning tasks that never get done, as the cooking and home baking for the residents is always a priority. The manager must review these hours again. Parklands DS0000007496.V309200.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35, &38 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users can be confident that the home is well managed. Systems and safeguards are in place to ensure the health, safety and welfare of service users and staff is protected EVIDENCE: There was an open, friendly culture between the management team and the staff at the home, and staff said they felt very well supported in their work. There was evidence is staff files that regular supervision of staff takes place and that staff are appraised. Service users said that the manager was very approachable and they would go to her if they had any concerns. Parklands DS0000007496.V309200.R01.S.doc Version 5.2 Page 19 The minutes of the last staff, resident and relative meetings were read, and action had been taken on matters arising from these meetings. The home holds personal allowance for some residents, records and money were checked and were satisfactory. The homes health and safety file was examined; all equipment in the home is regularly checked with valid certificates issued. There are no outstanding issues from environmental health inspections or the fire and rescue services. Parklands DS0000007496.V309200.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 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 3 X 3 X 3 X X 3 Parklands DS0000007496.V309200.R01.S.doc Version 5.2 Page 21 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. 1. Standard OP19 Regulation 13 Requirement The provider, together with the registered manager must draw up a program of refurbishment and redecoration for the home, with timescales for completion of this work and submit this to the Commission. Timescale for action 29/09/06 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 OP15 Good Practice Recommendations It is recommended that the manager review the staffing levels in the kitchen to ensure that cleaning tasks can be completed properly. Parklands DS0000007496.V309200.R01.S.doc Version 5.2 Page 22 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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