Inspection on 20/05/08 for Parklands Court Nursing Home

This inspection was carried out on 20th May 2008.

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 Court Nursing Home 18/05/07

Parklands Court Nursing Home 25/04/06

Parklands Court Nursing Home 30/01/06

Parklands Court Nursing Home 07/03/05

Parklands Court Nursing Home 07/09/04

Parklands Court Nursing Home 05/02/04

Parklands Court Nursing Home 24/11/03

Parklands Court Nursing Home 07/10/02

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Parklands Court Nursing Home 56 Park Road Bloxwich Walsall West Midlands WS3 3ST Lead Inspector Mandy Beck Unannounced Inspection 20th May 2008 09:30 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 Court Nursing Home DS0000020791.V355794.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 Court Nursing Home DS0000020791.V355794.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parklands Court Nursing Home Address 56 Park Road Bloxwich Walsall West Midlands WS3 3ST 01922 711844 01922 491137 dudda@bupa.com www.bupa.com BUPA Care Homes (CFHCare) Ltd 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) Amanda Dudd Care Home 163 Category(ies) of Dementia - over 65 years of age (73), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (73), Old age, not falling within any other category (163), Physical disability over 65 years of age (90) Parklands Court Nursing Home DS0000020791.V355794.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service users not to exceed the maximum number registered for at any one time. Of the 90 service users in the category PD(E), 29 may be accommodated at the home for intermediate care in the category PD. Service users in the categories PD(E), TI(E), MD(E) and DE(E) may be 50 years and over. 18th May 2007 Date of last inspection Brief Description of the Service: Parklands Court is set in attractive landscaped grounds, close to Bloxwich town centre, shops and public transport. The home provides nursing care to 163 people at any one time. There are five houses on this site. Each is dedicated to the care of older people all of which have differing needs. Samuel House offers intermediate care services to people. This means the home supports people with rehabilitation to enable them to go back home at the end of their stay whenever possible. Marlborough and Clarendon House both provide a caring environment for those people who have dementia. A new unit has also been created within Marlborough house; Elmore unit will offer intensive care for up to 13 people with dementia. At present this unit is not occupied. Collins and Harrison House offer care to older people who are frail and require nursing care. When people visit this home they will find the information they need in the administration building. They will find copies of recent inspection reports, BUPA’s own quality assurance publication and the homes Statement of Purpose and Service User Guide. The range of fees charged by the home are not included within the Service User Guide. Readers of this report are asked to contact the home directly for this information. Parklands Court Nursing Home DS0000020791.V355794.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We looked at all the information that we have received, or asked for, since the last key inspection. This included: • The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. • Information we have about how the service has managed any complaints. • What the service has told us about things that have happened in the service, these are called ‘notifications’ and are a legal requirement. • The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. • Relevant information from other organisations. • We also spent time talking to the people who use the service and to the staff who support them. • We looked at the care of fifteen people who use this service in depth. This is part of our case tracking process and helps us makes judgements about the home’s abilities to meet people’s needs. The quality rating for this service is 2 star. This means that people who use this service experience good quality outcomes. What the service does well: On each of the houses we visited people told us that they were happy there. They said “no one would choose to live in a nursing home but it is nice once you’ve made the decision”. The home has good systems in place for the assessment and planning of care needs for people. People can feel confident that their concerns and complaints will be listened to and acted upon by the staff in the home. The home is well managed and is run in the best interests of the people who live there. Parklands Court Nursing Home DS0000020791.V355794.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. The summary of this inspection report can be made available in other formats on request. Parklands Court Nursing Home DS0000020791.V355794.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 Court Nursing Home DS0000020791.V355794.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 Quality in this outcome area is good. People who may choose to use this service will have the information they need to be able to make a decision about living there. They can feel confident that their needs will be assessed in full prior to admission and that once they move in the home will be able to meet those needs. People using the rehabilitation service will be supported in their recovery and helped to maximise their independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides information to people about the services they offer. We looked at the Statement of Purpose and the Service User Guide. Both documents give an accurate picture of what people can expect from the service should they choose to live here. We made a recommendation for the home to include the range of fees they charge people for residency. This will give people more clarity about the fees they can expect to pay. People told us “There was an information pack in the room we chose. My sisters were taken Parklands Court Nursing Home DS0000020791.V355794.R01.S.doc Version 5.2 Page 9 around the house which we received all information regarding routines”. Almost half the people who responded to our survey said that they were given enough information about the home before they agreed to move in. During this inspection we looked at fifteen people’s care in depth as part of our case tracking process. It was pleasing to see that all of these people had their needs assessed in full prior to their admission and again when they had moved in. This means that both the people who use this service and the home can be satisfied needs are assessed in full and that the home is able to meet those needs. The home has a dedicated unit for short term rehabilitation. Samuel House is equipped to care for the specialist needs each person will require. Staff on this unit said that they had received training and understood the roles of the other disciplines in the recovery process for the people they supported. The home has an arrangement with the Walsall Primary Care Trust (PCT) to provide this specialist service. Once a decision had been reached for a person to enter an intermediate care bed an assessment of their needs is completed. The staff on the unit will do this in conjunction with the PCT. The initial assessment of need did include people’s aspirations. For example one said “would like to do jobs around the home current poor mobility means unable to do so” another said: “goal is to return home but says that current poor mobility means he is unable to do so”. Despite this initial comment about people’s goals there was no other reference to them and how or when they are achieving them. The home has some techniques for rehabilitation in place but we felt that improvements could be made to others. For instance we found that people are not supported to manage their own medication until a date for their discharge has been set. We have recommended that this happen at the point of admission so that detailed risk assessments can be carried out and people’s needs be identified earlier rather than later. We also found that in comparison to the home’s own QUEST assessment documentation the PCT’s Single Assessment documentation was not as detailed and did not always give staff the care direction that QUEST did. Care plans were not as detailed or as person centred as they could be. It was positive that staff were able to give us verbal updates about the care and support of the people on this unit. It demonstrated an understanding of their needs despite the limited information in people’s care plans. Parklands Court Nursing Home DS0000020791.V355794.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is good. People who use this service can feel confident their healthcare needs will be met. Improvements to record keeping will make sure all people’s needs are included in their care plans so that staff are clear about care delivery. Medication practices within this home are satisfactory and do protect the well being of the people who live there This judgement has been made using available evidence including a visit to this service. EVIDENCE: BUPA has developed their own QUEST system for the assessment, care planning and evaluation of people’s care. QUEST is comprehensive and guides staff when they begin to plan care for people. We looked at the care of fifteen people in depth as part of the case tracking process. We found that in the majority of cases care plans were completed, had been reviewed and did give a true reflection of people’s needs. The home routinely assesses people’s risk of falling, pressure sore risk development, moving and handling and also screens them for risk of malnutrition. We found risk assessments had in most cases been completed and regularly reviewed. This means that people’s needs Parklands Court Nursing Home DS0000020791.V355794.R01.S.doc Version 5.2 Page 11 are being kept under review and the home is able to take action if problems or deterioration occurs. Some people need specialist care in this home, particularly those people with dementia. It was pleasing to see that staff demonstrated a good understanding of people’s needs and how to manage difficult situations. Particularly when they found some behaviour challenging to deal with. We saw clear plans and behavioural charts in place to guide staff. The home also has the support from the Older Person’s Community Mental Health Team and has taken steps to provide care staff with training in Dementia care and person centred care. Staff we spoke to during the inspection said “we have had training but if you treat people with respect and recognise their needs caring for them is better, they seem more settled”. We looked at the care of people who had pressure sores. We found at times care records could be confusing and did not give us a clear record of treatment for each person. Care plans on the intermediate care unit contained limited information. For instance the care plan for one person made no reference to a pressure sore on their right hip. An entry in this persons daily notes indicated “dressing rolled off right hip very inflamed and black area needs swabs and review mane (morning)”. We found no further information recorded in relation to this pressure sore or whether it was swabbed or if there was a change of care or treatment. Nursing staff had recorded in the same person’s care plan treatment for another wound but not the wound on the right hip. Care plans did not always contain information of the pressure relieving equipment needed to help prevent further deterioration in their condition. We could not be assured that appropriate pressure area care would be given in this instance. Other care plans on other houses, for pressure relief and pressure sore care were much more detailed. One care plan described the care; the equipment needed and also had taken into account that pain relief may be needed during the wound dressing. In addition to this the nursing staff had also assessed this person’s experience of pain and had taken steps to address it. This is very positive practice and means that despite this person’s condition the home had recognised their needs and taken steps to meet them and keep them pain free. We looked at the care of some of the people who needed to be fed via a tube. Generally the care plans were satisfactory and did give enough information to staff about meeting people’s needs. However there are improvements needed and also a need for further training for some of the nursing staff who look after these people. Staff told us “we have a few forms to fill in, I haven’t had any training in caring for this but I can call another nurse on the site I feel there is a problem”. Some of the documentation the home has for recording feeds and treatment is not as robust as it could be and staff are completing it differently. This was discussed with the manager at the time of the inspection; she has agreed to look at this further so that continuity of care records is maintained. Parklands Court Nursing Home DS0000020791.V355794.R01.S.doc Version 5.2 Page 12 We found that people have access to a wide variety of healthcare professionals as their needs dictate. The home is in contact with physiotherapists, occupational therapists, community mental health nurses, and stroke team and speech and language therapists. Doctors regularly visit the home to see people. Relatives confirmed this during the inspection; they told us “if ever my husband is ill the doctor is called no matter what, they always keep me up to date”. Medication practices throughout the home are generally safe and do protect the people living there. The home has good systems in place for the ordering, receipt and administration of medication. There has been an outstanding requirement for the home to address some storage issues with medication. We looked at this on each house we visited. Medication is generally stored safely although there are occasions when the temperature in the treatment room is too high. This is a repeated requirement that is not met. The manager told us the home is installing new air conditioning units to make sure that this doesn’t happen in future. If this is not done we, the commission, will consider taking further action for this breach in regulations. Other small areas for improvement are staff to double sign Medication Administration Records (MAR) when making a handwritten entry. This will reduce the margin for error. We also found that some staff use a tick to indicate when external medicines such as creams and lotions have been administered. This is not good practice, nursing staff explained that they tick the box on the MAR if a carer has administered the cream; it was recommended that the carer sign the sheet if they have administered the cream. This will help make sure that all administrations are signed for and can be audited. The home is taking steps to support people with self-administration of medication in Samuel House. The process is not fully operational and people’s risk assessments are not being completed until almost the end of their stay. We have recommended that people be risk assessed to administer their own medication from the point of admission. This would ensure that any potential problems are highlighted and can be addressed before the person is discharged Generally we saw that people were treated respectfully and spoken to politely throughout the inspection. Staff were courteous and knocked on doors before they entered. And took care most of the time to maintain people’s dignity. There were one or two things that staff should be mindful of when talking to people or helping them. For instance we heard one carer tell a resident to “wee in your bag sweetheart that’s what its for”, and saw other carers taking people to the toilet in their armchairs but being pulled backwards towards the toilet. Neither of these observations particularly promote people’s dignity. Parklands Court Nursing Home DS0000020791.V355794.R01.S.doc Version 5.2 Page 13 People told us that they felt staff treated them with respect and dignity at all times. We saw evidence in QUEST documentation of the home working with people and their families completing life histories. Staff said “they have been good because you get to know things about people, like what they want and what they used to do, you see them more than just someone in a home you see the person”. Life history has also helped with the care planning and introducing people’s likes and dislikes into this process. Staff are taking time to record people’s preferences for care such as “likes to lie on her left side at night and has two pillows”, “likes to get up at 1am and have a cup of tea with two sugars in, then goes back to bed”. Parklands Court Nursing Home DS0000020791.V355794.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. People who use this service are supported to lead active lives. They are encouraged to maintain family contacts and links with the local community. Meals are generally of good quality and most of the people we spoke to said they were happy with the choices available to them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has two dedicated activity workers who offer support to people on all of the houses. People who answered our questionnaires gave us a mixed response to the activity provision in the home. Responses ranged from activities being available “sometimes, usually or never”. Staff told us that each house has its own designated day for activity. They said “to be honest the people on this house like the outside entertainers more because it’s the music they enjoy, they don’t get much from bingo or painting”. “Sometimes it would be nice to have something different for people to do, I think they get bored with the same things”. We spoke to some of the people living in the home they told us “at times it can be a bit depressing”, “they do try to keep us entertained”. We saw posters Parklands Court Nursing Home DS0000020791.V355794.R01.S.doc Version 5.2 Page 15 displayed in some of the houses offering people to opportunity to go to local attractions such a Twycross zoo and Sandwell Valley. We discussed activity provision with the manager who told us, activites are available for people to take part in but she did recognise the need for a change in approach and the amount of time given to activities. This is being looked at as part of the homes future improvement. The home has yet to arrange training for its staff on the principles of the Mental Capacity Act 2005. There are plans for one member of staff to attend a “train the trainer” day in this subject. Once this has been done staff in the home will then receive training from this person. This should help staff recognise their roles and responsibilities in supporting those people who cannot make decisions for themselves because of a lack of mental capacity. Relatives are encouraged to visit regularly. Some of the relatives we spoke to said they felt part of the care for their loved one. One person said, “I visit every day and to be honest so do others, we all get along together it’s a good atmosphere”. One area where families and friends feel they help is meal times. “I come in every day to help at lunch time, the staff won’t cope other wise”. We observed the lunchtime meal and saw that some people needed more assistance than others. We spoke to staff about this and they told us, “If the relatives didn’t come we’d struggle to get meals out and warm to everybody”, “It can be a problem when lots of people stay in their rooms, taking lots of trays”. This was discussed with the manager who has agreed to look at staffing levels around key times such as this to make sure people needs are being met. People have also made their views known to us about the quality of food the home delivers. One person said, “Being a large man I like large portions, there never seems to be enough of the foods I like”, another said, “I’d like more chips from the chips shop but they cost more than a penny bag these days”. “The food here is very good they always make sure there is enough for everyone”. People who answered our questionnaires said meals were satisfactory “sometimes or usually”. We did take time to sample the food on offer during the inspection. We noticed that the mashed potato had been fortified with cream to give it a more nutritious content, however the turkey was bland and very dry, vegetables were satisfactorily cooked and were tasty. Desert was apple and blackberry pie which was also tasty. The home is able to provide choices for people if they do not like what is on the menu. The home also caters for people with special dietary needs. Parklands Court Nursing Home DS0000020791.V355794.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. People who use this service can feel confident the home will listen to their concerns and act upon them. They can also feel assured the home will act in their best interests and protect them abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints policy and procedure. People can find this in the Service User Guide and throughout the home. We saw the home has good systems in place for recording all elements of complaints. They always respond to people’s concerns and keep clear records of any investigations they undertake. The manager also told us the organisation has a new Quality and Compliance department who also review the quality of complaint investigation and also if trends in people’s complaints are emerging. People who answered our surveys told us they “always” knew who to make their concerns known to. Relatives spoken to during this inspection said “I talk to the unit manager, if I didn’t get any joy I’d go the management offices”. Staff told us “refer people to the unit manager or the office so the manager can talk to them and try and sort it”. We talked to staff about safeguarding adults. They told us “its about keeping people safe and free from hurt”, “Give them comfort with everything, and keep them safe”, others said, “Make the residents safe- like using the side rails if Parklands Court Nursing Home DS0000020791.V355794.R01.S.doc Version 5.2 Page 17 the resident has a history of falls”. All of the staff we spoke to agreed that they had heard of the whistleblowing policy but some were unsure of the purpose of the policy in protecting people. The home has its own policy for protecting vulnerable adults but also needs to obtain a copy of Walsall Local Authority guidance too. We spoke to the manager about training for staff. Since our last visit the number of staff who have received training in Safeguarding adults has improved and this was evident when we spoke to staff. We have recommended staff are made aware of the local authority guidance this could be done in conjunction with the safeguarding training. The home is reporting incidents appropriately to Walsall Adult Protection team and has good links with them to ensure people’s safety. We also looked at methods of restraint in use at the home. We found people who required bed rails, had their needs assessed and this had been recorded although not always regularly reviewed. One person’s bed rail risk assessment had only been part completed. The manager must make sure that staff complete these risk assessments in full so that the home can satisfy itself people’s risk in using this equipment is kept up to date and is the most appropriate form of restraint to keep them safe. We saw staff records so that we could check the home’s recruitment practices and how it safeguards the people living there from unsuitable workers. It was pleasing to see that all staff who work at Parklands Court are checked against the Protection of Vulnerable Adults List (PoVA) and have a Criminal Records Bureau disclosure (CRB) prior to them commencing employment with the home. This practice will make sure that all reasonable steps have been taken to prevent unsuitable people from working with vulnerable people. Parklands Court Nursing Home DS0000020791.V355794.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. People live in pleasant surroundings, there is room for improvement but the home is addressing this. Generally the home is safe, clean and comfortable for the people living there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We visited all of the houses on the site during this inspection. Each one is pleasantly decorated some more recently than others. We saw people’s individual bedrooms, it was evident that people are encouraged to bring their own possessions in with them when they move in. The manager told us Marlborough house is due to be redecorated and refurbished in June. This is very positive, at present Marlborough House does not feel a homely place to be, there are missing curtains, worn furniture and chipped paintwork. Parklands Court Nursing Home DS0000020791.V355794.R01.S.doc Version 5.2 Page 19 We were also shown around the home’s newest wing, called Elmore and is located inside Marlborough house. It is almost ready for people to move into. Elmore is pleasantly decorated although there are one or two teething problems yet to be sorted out. The unit does not have its own medication storage room, a kitchenette to make drinks or snacks and observation of people could be problematical given the “L” shaped design of the unit. The manager is currently working with the organisation to iron out these issues before people move in. Clarendon house was pleasant and clean during this visit. People said, “Its been decorated looks better but I bet some bits need doing again”. We noticed one person was having particular difficulty watching the television, in the small quiet area before the main lounge. The reception for the television was so bad the picture was barely visible. It is recommended this be sorted out for people to enjoy the television in this part of the home. Samuel House is clean and hygienic. This house is equipped with all the hoists, trolleys and specialist equipment needed to support the rehabilitation of people back to their own homes. Harrison and Collins house were again clean, odour free and generally well maintained. We saw that gloves, aprons and liquid soap were freely available for staff to use to prevent the spread of infection throughout the home. Staff are also receiving infection control training. The home has good arrangements for the laundering of people’s clothing and linen. Sluice cycles on washing machines ensure that linen is washing a disinfection temperatures further protecting people from the risk of infection. Parklands Court Nursing Home DS0000020791.V355794.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. People who use this service are supported by enough staff to meet their needs. The home will need to keep this under review as people’s needs change. New workers are recruited safely which means unsuitable people are prevented from working with vulnerable people. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since our last visit the manager has reviewed the staffing levels on each of the houses. Staff on each of the house we spoke had a mixed response to this but the majority of them were happy with staffing levels. They told us “I think we have enough staff now to meet residents needs”, “Sometimes when staff go off sick we have to cover other units this leaves us short, I don’t think they understand that”. “We have a staffing coordinator now but to be honest I think we manage”. The manager told us that staffing levels are looked at on a daily basis and are reviewed, as people’s needs change. The home supports new and existing staff in completing their National Vocational Qualification (NVQ) Level 2 in care. At present the number of care staff with this qualification is not quite 50 but the home is taking steps to make sure staff complete their NVQ training. This will mean that more staff will have the knowledge and skills to enhance their practice. Parklands Court Nursing Home DS0000020791.V355794.R01.S.doc Version 5.2 Page 21 Both the manager and deputy manager have worked hard to reorganise and arrange training for staff. This means that the home now has clear records of when each workers need for training is due and can take steps to arrange it for them. We saw the training matrix for the home and despite some gaps we are confident the home has made arrangements for these gaps to be addressed. We looked at the recruitment files for six workers at the home. We found a couple of minor omissions in paperwork but the home does take care to recruit people safely. All staff have safety checks such as a Protection of Vulnerable Adult list (PoVA) and Criminal Records Bureau disclosure (CRB), the home asks for two written reference from each employee and check their identify before they commence employment. This will help ensure the home does not recruit people who are unsuitable to work with vulnerable adults. There are good systems in place to support new workers through an induction programme once they begin working in the home. The home has a ‘Skills for Care’ Induction, which is filled in every quarter during supervision with Senior Care. One new worker told us, “Suddenly in the last 3 months I feel more confident – may do NVQ next”. Parklands Court Nursing Home DS0000020791.V355794.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This home is well managed and run in the best interests of the people who live there. People’s need for health and safety is protected by the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s manager is Amanda Dudd, and has been in post at Parklands Court for almost a year. She has extensive experience in managing nursing home’s and understands what needs to be done to move a service forward for the benefit of the people living there. She told us about improvements the home has made since she arrived, such as reviewing staffing levels, improving opportunities for staff training and developing the dementia care services on Elmore unit. Parklands Court Nursing Home DS0000020791.V355794.R01.S.doc Version 5.2 Page 23 She understands the running of the home and the areas of practice that still need to be improved upon. BUPA has good systems in place for finding out the views of the people who live there. The organisation consults with people on a regular basis asking them to complete satisfaction surveys, give their comments and make suggestions on improvements. Recently over 80 of people said the home “Treats you as an individual”. Other results showed that people were happy with the care they received, the food they ate and the cleanliness of the home. In addition to this the manager completes her own audit on quality and submits them to the Quality and Compliance Department where the results are analysed and recorded. The home also arranges for the safekeeping and administration of people’s money. People can deposit money with the administration office and this will be paid into the bank for them. Each person has their own account and can access the system each weekday. Money is available on weekend but a little forward planning is required to ensure that it is withdrawn by Friday for use at the weekend. Most of the people whose monies we looked at used this facility to pay for hairdressing or newspapers and sweets. One person told us, “It gives me peace of mind knowing it is there safe”. We looked at staff training in health and safety and other required areas. As previously mentioned the home is taking action to make sure that all staff receive training as and when the need it. The home has also told us in their annual quality assurance assessment (AQAA) that health and safety checks for the home are up to date and kept under regular review. We spot checked fire systems, fire drills and training and were satisfied the home is doing this in order to protect the people living there. Parklands Court Nursing Home DS0000020791.V355794.R01.S.doc Version 5.2 Page 24 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 2 X 3 X X 2 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 2 13 3 14 2 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 3 X 3 X 3 X X 3 Parklands Court Nursing Home DS0000020791.V355794.R01.S.doc Version 5.2 Page 25 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 OP9 Regulation 13(2) Requirement Medication must be stored in accordance with manufacturers’ instructions This is to ensure that medication is stored correctly to prevent people being placed at risk of harm and from receiving ineffective medication. (Previous timescale of 31/05/06 and 15/06/07 not met) Timescale for action 20/05/08 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 OP1 Good Practice Recommendations The statement of purpose and service user guide should be reviewed and amended. This will ensure that people admitted to the home are provided with up to date information on the fees charged and the services offered by the home. The home should promote people’s independence by planning for their discharge with clear goals from the point DS0000020791.V355794.R01.S.doc Version 5.2 Page 26 2 OP6 Parklands Court Nursing Home 3 4 5 6 7 OP7 OP8 OP9 OP12 OP14 8 OP18 9 OP26 of admission to the home. The home should give consideration to reusing the QUEST documentation on Samuel House to support the less robust Single Assessment Process paperwork. Care plans need to be in place for each person’s needs so that staff are aware of them and can act appropriately. Staff must not use ticks on MAR sheets as records of administration, it is recommended the member of staff who administers the cream or lotion does this. Activities could be better organised so that there is a more individual feel to their planning rather than a “one size fits all” approach. It is recommended that staff receive training in the principles of the Mental Capacity Act 2005 and gain an understanding of their roles and responsibilities in supporting people who may not be able to make decisions as a result of a lack of capacity It is recommended the home introduces the local authority guidelines into its safeguarding training for staff. This will ensure that staff are aware of local procedures and take appropriate action. All parts of the home, including chairs must be kept clean and in a good state of décor. This is to ensure people are provided with a clean and homely place to live. It is recommended the provider considers the installation of a urinal on Marlborough house for people to use 10 OP21 Parklands Court Nursing Home DS0000020791.V355794.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Court Nursing Home DS0000020791.V355794.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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