Inspection on 23/11/06 for Parklands Care Centre

This inspection was carried out on 23rd November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Parklands Care Centre 18/06/08

Parklands Care Centre 12/07/07

Parklands Care Centre 02/03/06

Parklands Care Centre 22/11/05

Parklands Care Centre 25/01/05

Parklands Care Centre 04/08/04

Parklands Care Centre 15/01/04

Parklands Care Centre 25/06/03

Parklands Care Centre 03/12/02

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

CARE HOMES FOR OLDER PEOPLE Parklands Care Centre 67 Broom Lane Salford Manchester M7 4FF Lead Inspector Elizabeth Holt Unannounced Inspection 23rd November 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 Care Centre DS0000006718.V299829.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 Care Centre DS0000006718.V299829.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parklands Care Centre Address 67 Broom Lane Salford Manchester M7 4FF 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) 0161 792 2020 0161 792 8778 Exceler Healthcare Group PLC Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Parklands Care Centre DS0000006718.V299829.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. A maximum of 40 service users who are over 65 years of age and who require either nursing care or personal care only can be accommodated. Minimum nursing staffing levels as specified in the Notice issued in accordance with Section 25(3) of the Registered Homes Act 1984 on 11 February 2002 shall be maintained. Minimum staffing as specified in the Residential Care Forum guidance for older people must be maintained for service users who require personal care only. The needs of service users must be continually assessed and staffing levels adjusted to ensure their needs are met. The home should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 2nd March 2006 Date of last inspection Brief Description of the Service: Parklands Care Centre is a care home providing nursing and personal care for 40 residents. Up to 11 residents must require personal care only and shall be accommodated in a designated area on the first floor. There are 36 single bedrooms and 2 twin bedded rooms situated within three floors. The residents that were accommodated at the home were mainly of the Jewish faith. All Jewish traditions were observed. A Shomer was employed as part of the staff team and he offered guidance and support to the other members regarding religious practices and cultural observations. A full Kosher menu was provided. The home is located off a main road in a quiet residential area of Salford with car parking located at the front of the building. The grounds were well maintained with a small garden area to the front and a terraced patio area to the rear, which was accessible from the dining room. Both areas were well equipped with garden furniture. Parklands Care Centre DS0000006718.V299829.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was unannounced and took place on the 23rd November 2006 and a further visit to the home was made on the 15th December 2006. All the key National Minimum Standards (NMS) were reviewed during this inspection. Information was gathered as part of the inspection process, which included a questionnaire completed by the manager, which gave information about the residents, the staff and the building. Information held by the Commission, such as, notifications of significant incidents was also reviewed. Time was spent talking to the residents, visiting relatives, the deputy manager and the staff team about day-to-day life in the home and to establish what the home was like for the residents living there. A partial tour of the premises was undertaken and documents and care files for the individual residents were examined. What the service does well: Residents were positive about the staff in the home. One resident said, “ The staff are very kind and are around to help me.” The home has a programme of activities and employs the services of an activities organiser. Residents who could express a view said they enjoyed the activities and trips out provided. The staff helped residents to make choices and have control where possible over their daily lives. Staff were encouraged to attend training courses and study days as appropriate. A sample of staff files were reviewed and these were generally in line with the required information. There was no evidence to show that interview notes were made and a recommendation was made. The home had an open visiting policy and the residents and relatives spoken to said they could have visitors at any time. A choice of food is available at each meal and the residents were happy with the food provided. Policies and procedures were available relating to Adult Protection and staff had received training in the protection of vulnerable adults. Parklands Care Centre DS0000006718.V299829.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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 Care Centre DS0000006718.V299829.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 Care Centre DS0000006718.V299829.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): 3 and 6 Quality in this outcome area is adequate. This judgement has been made using evidence made available and following a visit to the home. Procedures were available to ensure the needs of prospective residents are fully assessed before an offer of a place is made to the home. However the documentation was not fully completed which has the potential for residents’ needs to not be fully met. EVIDENCE: The files of two residents who were recently admitted to the home on the first floor (Shalom Unit) were reviewed. A pre admission assessment form was available in the residents’ file to record the assessment however these were not fully completed. For residents who are referred through Care Management arrangements the home obtains a summary of the assessment prior to admission. Copies of these were seen for two residents. Parklands Care Centre DS0000006718.V299829.R01.S.doc Version 5.2 Page 9 There was evidence to show that the admission process did include the involvement of the prospective resident and his/her representative when possible. The home does not provide an intermediate care service. Parklands Care Centre DS0000006718.V299829.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 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Each resident had an individual plan of care, however some areas of the plan required improvements to ensure residents’ health, personal and social care needs are fully met. Some improvements were required in the procedures for dealing with medication in order to fully protect residents. EVIDENCE: A sample of residents care files were reviewed and a number of concerns were identified. The care plans did not detail the specific action required of the staff to meet the residents’ changing healthcare needs. For one resident, comments in the daily statement gave remarks regarding a swollen leg. There was evidence of liaison with the General Practitioner, however there was no care plan generated for this new problem identified. For another resident there were a number of entries in the daily statements regarding ‘red eyes’. On some days staff recorded they bathed the resident’s eyes, however this was not on a regular basis. Again there was no care plan made to give the staff specific instruction on how to manage this problem identified. For one resident Parklands Care Centre DS0000006718.V299829.R01.S.doc Version 5.2 Page 11 a comment was made in the daily statement that two bruises were noted on a resident’s right hand. There was no further recording of any action taken. Other daily statements included the following comments; ‘good day’, ‘good night’. These should include more detail and be linked to the problems identified. The evaluations of the care plan regularly stated, ‘care plan stays the same’ or ‘no change’ and did not show evaluations of the changes in healthcare needs. Gaps were noted in the following areas: recording of monthly weights, records of professional visits and recordings of dates when risk assessments were implemented. It was pleasing to see that some of the information provided in the care plans was personalised with attention to detail. Wound care plans were clear with detailed information. Policies and procedures were in place for the administration and handling of medicines. Although medication charts included photographic identity, some shortfalls were noted following a review of the medication administration charts (MARS). These shortfalls included the following; where codes had been used the reason for medications not being administered was not always filled in (particularly evident on the nursing floor). Gaps were noted for the omission of a number of medications. Requirements have been made for a full audit of the home’s medication administration and for staff training to include the recording on the medication administration records. Staff were observed addressing the residents respectfully. Parklands Care Centre DS0000006718.V299829.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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents found the lifestyle experienced in the home matched their expectations and preferences. Activities were provided and residents could exercise choice over their lives. A wholesome balanced diet was provided for the residents. EVIDENCE: The home supports the residents to meet their individual lifestyles. An activities organiser is employed for 25 hours per week. Ten hours of this time is spent on the first floor with the elderly residents. A rolling programme of activities is provided and residents spoken to said they were happy with the activities the home provided. Some residents said they had recently been to the cinema, done some flower arranging and were escorted to the shops. A pantomime was planned and a reminiscence group was held regularly. The home has an open visiting policy that allows residents, friends and family to visit during the day. The residents are able to receive visitors in private. Two visitors confirmed this was the case and they were always made to feel welcome in the home. Parklands Care Centre DS0000006718.V299829.R01.S.doc Version 5.2 Page 13 The home continues to provide good quality wholesome meals. The menu is varied and nutritious with a Kosher kitchen and aims to respect residents’ individual requirements. Residents said the food was good and there was always plenty to eat. Some residents said they were confident that the Sabbath and religious festivals and traditions were maintained. This included holding services in the home’s on site synagogue. Parklands Care Centre DS0000006718.V299829.R01.S.doc Version 5.2 Page 14 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has policies and procedures in place for making complaints and residents and relatives were confident the home would deal with these appropriately. EVIDENCE: Residents and relatives said they knew how to make a complaint and felt confident their complaint would be dealt with appropriately. The Commission for Social Care inspection have not been in receipt of any complaints/concerns since the last inspection. Policies and procedures were in place to help the staff protect the residents from harm or abuse. Staff spoken to were aware of what to do in the event of an allegation of abuse and confirmed they had received training in Adult Welfare. Parklands Care Centre DS0000006718.V299829.R01.S.doc Version 5.2 Page 15 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment was safe and the residents live in a clean and wellmaintained home. EVIDENCE: The home was generally very clean and the hallway had been re-carpeted since the last inspection. There was no offensive odour noted throughout the home. There is a programme in place to redecorate and refurbish the home and this is ongoing. The bedrooms were pleasantly decorated and personalised. During a partial tour of the building it was noted that the plug socket in bedroom 12 was broken and the door was ill fitting on the bedside cabinet. On the Shalom Unit it was pleasing to see the thought and effort that had gone into the decoration of the walls, the resident’s names, photographs and an individual door knocker. Parklands Care Centre DS0000006718.V299829.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The number and deployment of staff appeared sufficient to meet the needs of the residents’ assessed needs. The procedures for recruiting staff were robust and provided safeguards to protect the residents. EVIDENCE: The numbers and skill mix of the staff appeared sufficient to meet the care needs of the 25 residents accommodated at the time of this inspection. However, some concerns were raised in relation to the home not recognising in full the healthcare needs of a resident accommodated on the Shalom Unit. Staff were prompted to seek appropriate professional advice and to ensure the care plan provides the appropriate triggers for the staff to recognise when medical/nursing input is required. Following the second visit it was pleasing to see the home had taken action to review the resident’s needs however there were some shortfalls in the care plan (See Health and Personal care). A requirement was made for a full audit of care plans to ensure the healthcare needs of residents are fully met. Staff files examined contained the required information; however there was no evidence to show any notes made at the interview and a recommendation was made. The home employs 10 care staff. 2 carers have successfully achieved NVQ level 2. Parklands Care Centre DS0000006718.V299829.R01.S.doc Version 5.2 Page 17 Records showed there was a rolling programme of training available for staff. Parklands Care Centre DS0000006718.V299829.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 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The policies and procedures safeguarded the rights and best interests of the residents. EVIDENCE: The manager has been in post for a number of months and a requirement was made that she must submit her application to be registered with the Commission for Social Care Inspection. The manager was not on duty on the two site visits made by the Commission. A questionnaire was available to seek the views of residents/relatives. There was no evidence to suggest this had been sent out in the last 6 months. Parklands Care Centre DS0000006718.V299829.R01.S.doc Version 5.2 Page 19 Fire safety checks were being carried out on a regular basis. The fire risk assessment had not been fully completed and had not been signed or dated. Staff had attended a recent fire drill. The home has procedures in place to manage the finances of the residents. Records showed that the financial interests of the residents were safeguarded. The pre inspection questionnaire showed that regular health and maintenance checks Parklands Care Centre DS0000006718.V299829.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 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 x 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 3 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 2 X 3 X 3 X X 2 Parklands Care Centre DS0000006718.V299829.R01.S.doc Version 5.2 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 OP3 Regulation 14 Requirement The needs of the residents must be fully assessed before admission to the home is confirmed. Timescale for action 12/02/07 2. OP8 13 A full audit of all the care plans 12/02/07 must be carried out to ensure that each resident has an individual plan of care that accurately details the health, social and personal care needs of the residents accommodated. An application must be made to the Commission for the registration of the manager. An up to date fire risk assessment should be made available with a copy forwarded to the Commission. 28/02/07 3. OP31 9 4. OP38 23 12/02/07 Parklands Care Centre DS0000006718.V299829.R01.S.doc Version 5.2 Page 22 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 OP29 Good Practice Recommendations It is strongly recommended that copies of interview notes are held as part of the recruitment process. Parklands Care Centre DS0000006718.V299829.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection CSCI, Local office 11th Floor West Point 501 Chester Road Old Trafford, Manchester M16 9HU 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. 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