CARE HOMES FOR OLDER PEOPLE
Parklands Station Road Rawcliffe Goole DN14 8QP Lead Inspector
Rosalind Sanderson Unannounced 8 September 2005 10:00
th 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. Parklands J53 J04 S19705 Parklands V242268 080905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Parklands Address Station Road Rawcliffe Goole DN14 8QP 01405 839226 01405 839699 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) Humberside Independent Care Association Limited Mrs Caron Lesley Rogers Care Home Only 30 Category(ies) of OP Old Age (30) registration, with number DE(E) Dementia - over 65 years old (30) of places Parklands J53 J04 S19705 Parklands V242268 080905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 21/3/05 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 J53 J04 S19705 Parklands V242268 080905 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over one day and lasted for seven and a half hours including preparation. The private and communal accommodation were looked at. Records inspected included service user files, staff records, financial records and health and safety certificates. Service users and staff were spoken with and prior to the inspection 27 comment cards were sent out to service users next of kin or their representatives in order to get their views about the service. 24 of these cards were returned with mostly positive comments made about the home. Comments received will be included within the report. The manager was available throughout the inspection. What the service does well: What has improved since the last inspection?
Since the last inspection recording practices for medication has improved and staff involved with the administration of medicines have received training ensuring that all medication is stored and handled safely. NVQ training is encouraged and promoted and the home is well on target to meet the 50 requirement by the end of this year.
Parklands J53 J04 S19705 Parklands V242268 080905 Stage 4.doc Version 1.40 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 J53 J04 S19705 Parklands V242268 080905 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 Parklands J53 J04 S19705 Parklands V242268 080905 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. (6 is not applicable) Residents can feel confident that their assessed needs will be met. EVIDENCE: A selection of care plans were looked at and each one contained a preadmission assessment that had been completed where possible prior to admission. In one case the assessment had been completed following admission but within one day. The assessment was in some cases in addition to the care management assessment. Service users spoken with confirmed that they had been asked about their healthcare needs. The registered manager confirmed that all residents have a needs assessment carried out preferably prior to admission but definitely as soon as possible following admission so that the staff can confirm to the resident that these needs will be met. Parklands J53 J04 S19705 Parklands V242268 080905 Stage 4.doc Version 1.40 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 standard(s) 7,8,9,10 Residents are cared for safely and in accordance with their individual care plan. EVIDENCE: Each resident has an individual care plan detailing how the health and social needs identified at the assessment will be met. Where possible these plans have been signed by the resident to indicate their agreement. The plans are reviewed on a monthly basis to ensure they remain relevant and up to date. Residents that have been admitted under the care management approach also have annual reviews. Relatives and representatives are invited, with the residents consent to ensure that all involved in the care of the resident are aware of progress. One service user commented ‘I am well looked after and the staff make sure I get to my hospital appointments.’ Staff were observed during the inspection interacting well with service users and giving them time to express their views. They were also observed to knock on bedroom doors and residents confirmed that their privacy is respected. Parklands J53 J04 S19705 Parklands V242268 080905 Stage 4.doc Version 1.40 Page 10 Comments received from residents included, ‘Staff always knock on my bedroom door and wait for me to answer before entering. If I have a bath I am left to wash myself in private but always have a call bell at hand.’ Relatives comments included, ‘I am extremely satisfied with the care that receives in Parklands. The staff and management keep me informed of everything. It is a lovely home.’ ‘What is there not to like at Parklands? The systems in place to address the safe handling and administration of medicines ensure that residents receive their medication safely and correctly. The manager audits the MAR sheets monthly and addresses any errors individually in staff supervisions. Residents are provided with lockable space in their rooms for safe storage of medicines should they wish to self medicate. No resident self medicates at the moment. Parklands J53 J04 S19705 Parklands V242268 080905 Stage 4.doc Version 1.40 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 standard(s) 12,13,14,15 Residents are satisfied with the lifestyle they experience but would welcome more regular organised activities. The cook provides a well-balanced varied diet to suit collective and individual needs of the residents. EVIDENCE: The home arranges monthly outings for the residents that are enjoyed by all residents spoken with. Residents commented, ‘I love the rides out and enjoyed the recent trip to Scarborough’. Places on these trips are limited owing to the size of the minibus and the number of carers required to assist residents but places are allocated fairly. A lot of positive comments were received regarding the dinner dances that the manager and staff arrange every three months. It was obvious when speaking with service users that the dinner dances are greatly appreciated and enjoyed. These events are themed, for example, Hawaiian nights and resident’s families and friends attend. A dinner is provided with wine and thoroughly enjoyed by all who attend. Comments received included, ‘I love the dinner dances that are arranged and it is nice to see visitors that come to them’ ‘It was my birthday and we had a ‘good old days’ party, it was lovely. Parklands J53 J04 S19705 Parklands V242268 080905 Stage 4.doc Version 1.40 Page 12 Residents also explained that they attend the local church and are assisted in getting there by staff or by helpers from the church. Although residents are satisfied with the activities on offer a few expressed the wish to have more regular activities and even on an individual basis such as going out for a walk around the village or visiting the local pub. Staff arrange activities as and when they are able and on occasions in their own time. Staff spoken with felt that the home and residents would benefit from an activities organiser who could focus on day-to-day activities and residents spoken with would certainly welcome this. A recommendation is made regarding this in this report. The cook has been employed at the home for many years and is enthusiastic about her role. She is knowledgeable about individual residents dietary needs and discusses these with residents on a regular basis. She provides residents with a wholesome, varied diet and the residents were appreciative of this. One said, ‘The home is first class and the food lovely. You always get a choice’ The lunch served was well presented and looked appealing. Staff were observed giving help to those requiring it in an appropriate fashion. Parklands J53 J04 S19705 Parklands V242268 080905 Stage 4.doc Version 1.40 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 standard(s) 16&18 Residents are protected and can be confident that any complaint they may have will be listened to and acted upon. EVIDENCE: Residents spoken with know who to approach if they have a complaint or concern. One resident said ‘If I had to complain I would see the manager but usually my key worker sorts things out.’ A visitor spoken with gave the same response. The complaints book was looked at and showed that complaints are acted on and investigated within the agreed timescales. Actions taken and whether the complainant is satisfied are also recorded. A recent complaint that was investigated by Goole social services was partly upheld and the manager had put policies and procedures in place to ensure any shortfalls in care that were identified were addressed. There was no record of this complaint in the complaints file and a requirement was made that records are kept in accordance with the Care homes Regulations 2001. All staff receive training in the Protection of Vulnerable Adults and staff spoken with were clear about what action they would take in the event of a disclosure of abuse. The home has a copy of the Local Authority Multi Agency Policy. Parklands J53 J04 S19705 Parklands V242268 080905 Stage 4.doc Version 1.40 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 standard(s) 19 & 26 Residents live in a safe and well maintained environment. Attention is needed in the sluice and laundry areas to ensure that these areas are clean and hygienic. EVIDENCE: The home is suitable for its stated purpose and an ongoing programme of renewal and maintenance is in place. The building is safe and complies with the local fire authority requirements. Staff receive training in the prevention of cross infection as part of their induction and there was evidence of staff being provided with personal protective equipment. There is a sluice room and a laundry that each have a sluice hopper in place. It was noted at the inspection that these were both very dirty and stained. In the laundry room there had been work carried out on the walls that meant the walls were not washable and the seals on the floors had been compromised so that the floor was permeable to water so again they were not easily washable.
Parklands J53 J04 S19705 Parklands V242268 080905 Stage 4.doc Version 1.40 Page 15 The manager is required to give this area urgent attention to prevent any possible spread of infection. Parklands J53 J04 S19705 Parklands V242268 080905 Stage 4.doc Version 1.40 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 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) 27,29&30 Residents are cared for by staff that are safe and well trained. Staffing numbers must be reviewed to ensure residents have attention promptly at all times. EVIDENCE: The organisation operates a thorough recruitment procedure that ensures all staff employed are safe to care for the residents. Staff spoken with were appreciative of the training provided by the organisation that includes all mandatory training and training to assist staff to meet the needs of the service user group. Comments received from eight relatives via the comment cards expressed concern about the numbers of staff on duty at times. One commented that at times the shortfall led to residents waiting for attention especially over mealtimes. Another relative stated the situation had improved over the last month. The manager stated that they had had recent problems but had recruited carers from Poland who were now in post following their induction. A worker spoken with confirmed that they had been recently recruited and undergone the induction process. At this inspection staff were observed taking residents to the dining room at 11.20 a.m. for lunch that was to be served at 12.15 p.m. These residents were seen to be waiting for assistance back to their rooms at 13.35p.m. following their lunch. One resident said, ‘They will come eventually, you have to wait.’
Parklands J53 J04 S19705 Parklands V242268 080905 Stage 4.doc Version 1.40 Page 17 The registered manager must review the staffing to ensure that sufficient staff are on duty at busy times of the day to prevent residents having to wait for assistance. Parklands J53 J04 S19705 Parklands V242268 080905 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) 33,35 &38 The registered manager conducts the running of the home in the best interests of the residents and ensures that the safety of service users and staff are promoted and protected. To ensure that residents financial interests and health and welfare continue to be promoted the requirements made in this report must be addressed. EVIDENCE: The manager is experienced and competent to manage the home. She has gained the registered managers award. All certificates relating to health and safety are current so that all systems and appliances are safe to use. Mandatory training for staff is current ensuring residents are cared for by safe staff. Relevant legislation is complied with and specific and generic risk assessments are in place and reviewed to promote safety within the home. Parklands J53 J04 S19705 Parklands V242268 080905 Stage 4.doc Version 1.40 Page 19 The quality assurance systems in place ensure that the manager takes into account the views of all residents where possible and their relatives. Results of surveys are analysed and the results published. The home also produces a regular newsletter for residents and their visitors. Results of surveys assist the manager to develop the annual development plan. The process ensures that residents and relatives feel involved in the running of the home and that they have a say in it. It is recommended that the views of other stakeholders are sought for future audits including staff, healthcare professionals and care managers. The home holds personal monies for a 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. Cash held in the home for residents is kept collectively in a single cash box. The home is able to produce individual accounts for each service user. However, in some circumstances residents accounts may fall into 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 J53 J04 S19705 Parklands V242268 080905 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 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 x x x x x x 1 STAFFING Standard No Score 27 1 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 x 3 x x 2 x 1 x x 3 Parklands J53 J04 S19705 Parklands V242268 080905 Stage 4.doc Version 1.40 Page 21 NO 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 18 Regulation 17(2) schedule 4 para. 11 Timescale for action The registered manager must On receipt ensure that a record is kept of all of this complaints made to the home. report and This record must include maintained outcomes and details of what thereafter. action was taken as a result of the complaint. The registered manager must: Put in place a system to ensure that the sluice hoppers are kept in a clean and hygienic state. On receipt of this report and maintained thereafter Requirement 2. 26 23(2(d)) Arrange for refurbishment of the 8/12/2005 sluice and laundry to ensure that they do not pose a risk to health and safety. 3. 27 18(1(a)) The registered manager must keep staffing numbers under review and make sure that there are adequate staff on duty at busier periods to give residents prompt assistance. On receipt of this report and maintained thereafter Parklands J53 J04 S19705 Parklands V242268 080905 Stage 4.doc Version 1.40 Page 22 4. 35 13(6) The registered manager must: Make sure that 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 On receipt of this report and maintained thereafter. 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. 2. Refer to Standard 12 33 Good Practice Recommendations Consideration should be given to employing a dedicated activities organiser so that activities can be arranged on a more frequent and regular basis. It is recommended that the registered manager seeks the views of other stakeholders about the service offered. These stakeholders could include G.Ps, visiting professionals,staff and care managers. Parklands J53 J04 S19705 Parklands V242268 080905 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection York Area Office Unit 4, Triune Court Monks Cross York, YO32 9GZ 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 J53 J04 S19705 Parklands V242268 080905 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
