Inspection on 11/06/07 for Parklands Nursing Home

This inspection was carried out on 11th June 2007.

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 Nursing Home 12/01/07

Parklands Nursing Home 10/05/06

Parklands Nursing Home 23/12/05

Parklands Nursing Home 04/07/05

Parklands Nursing Home 27/09/04

Parklands Nursing Home 05/05/04

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

CARE HOMES FOR OLDER PEOPLE Parklands Nursing Home 33 Newport Road Woolstone Milton Keynes Buckinghamshire MK15 0AA Lead Inspector Joan Browne Unannounced Inspection 09:30 11th June 2007 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 Nursing Home DS0000019248.V337328.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 Nursing Home DS0000019248.V337328.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parklands Nursing Home Address 33 Newport Road Woolstone Milton Keynes Buckinghamshire MK15 0AA 01908 692690 01908 231329 manager@pnh.demon.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Vaz Mrs M Officer Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Parklands Nursing Home DS0000019248.V337328.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th January 2007 Brief Description of the Service: Parklands is a small privately owned care home, registered to provide nursing care and accommodation for thirty older people. The home is situated in the Woolstone area of Milton Keynes and is within a short journey of the town centre, where a varied range of amenities and facilities can be found. Parklands has twenty-two single bedrooms and four shared rooms. Some of these were being used as single rooms at the time of the inspection. All bedrooms are fitted with adjacent en-suite facilities and are on the ground floor. The lounge/dining room is fitted with four sets of French doors, which offer immediate access to the patio area and grounds beyond. Extensive welltended gardens surround the home. Fees range between £595 and £705 per week depending on the room available and service users’ care needs. Information about the home can be obtained by telephoning or visiting the home. Parklands Nursing Home DS0000019248.V337328.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 09.30 and was in the service for approximately nine hours. It looked at how well the service was doing and took into account detailed information provided in the annual quality assurance assessment form, and any information that the Commission had received about the service since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to comment cards that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. It was felt that the home was providing an adequate service to ensure that individuals’ cultural, religious and diverse needs were being met. Staff’s practice was observed and care plans were examined. This was followed by meeting with individuals to see if the plans matched the assessed care needs. The medication administration record sheets, service users’ personal allowance transaction sheets and staff recruitment files were examined along with the accident book and fire record. A tour of the premises was conducted. The inspector spent some time meeting with service users, staff and visitors. The inspector would like to thank everyone who assisted in this inspection in any way. What the service does well: Information about the service is contained within a statement of purpose and service user’s guide so that prospective service users and their families have the necessary information to help make a decision about moving into the home. No service user moves into the home without having his/her needs assessed to ensure that the home could meet the assessed needs. There is regard for service users’ privacy and dignity and they are treated with respect ensuring that care is provided sensitively. The home ensures that service users’ social religious, cultural and recreational needs are met. Parklands Nursing Home DS0000019248.V337328.R01.S.doc Version 5.2 Page 6 Service users are supported and encouraged to maintain contact with family, friends and the local community. Meals and mealtimes are well managed ensuring that service users’ nutritional and dietary needs are met. A complaints procedure is in place to ensure that service users and their representatives’ views are listened to. There is effective management at the home to ensure continuity of care and that the home is run in the best interests of service users. What has improved since the last inspection? What they could do better: Care plans must be detailed to ensure that care provided is person centred. The medication process must be improved to reduce any potential risk of harm to service users. The broken clinical waste bin in the assisted bathroom must be replaced to prevent any risk of infection to service users. Parklands Nursing Home DS0000019248.V337328.R01.S.doc Version 5.2 Page 7 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 Nursing Home DS0000019248.V337328.R01.S.doc Version 5.2 Page 8 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 Nursing Home DS0000019248.V337328.R01.S.doc Version 5.2 Page 9 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): 3 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures that prospective people to use the service have their needs assessed before they are admitted to the home and are assured that all identified needs would be met. The home does not provide intermediate care. EVIDENCE: The home’s statement of purpose and service user’s guide was displayed in the reception area. At the previous inspection a recommendation was made for the documents to be made available in other formats to assist service users with a sensory deficit. It is pleasing to report that the documents were now available in a large font. Case tracking confirmed that the home ensures that a pre-admission assessment of individuals’ care needs is carried out. The assessment forms Parklands Nursing Home DS0000019248.V337328.R01.S.doc Version 5.2 Page 10 the basis of the care plan. The pre-admission assessment format that is used covered personal and health care needs. One sevice user remembered being visited in hospital by the home’s staff but could not remember being given a copy of the service user’s guide. The manager confirmed that a copy of the home’s statement of purpose and service user’s guide was issued. Another service user spoken to said that ‘he was happy living in the home and staff were meeting his physical care needs’. There were some concerns raised about his spiritual needs that were not being fully met. The individual had requested to continue practicing his faith and attend a place of worship on a regular basis. The home’s manager said that she was aware of the unmet need and was working with the individual’s family to ensure that the need to attend a place of worship on a regular basis would be fully met. Parklands Nursing Home DS0000019248.V337328.R01.S.doc Version 5.2 Page 11 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 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People who use the service are being placed at risk by staff’s inconsistent practice in the administration and recording of medication. Actions in care plans need to be more detailed to enable all staff to care appropriately for people who use the service diverse needs. EVIDENCE: Three care plans were examined. Plans were signed by individuals or their representatives to confirm their involvement. The nurse manager said that she had started reviewing individuals’ care plans with service users and their representatives. However, the process was not fully implemented. Information in care plans was recorded in key areas such as hearing and communication, foot care, medication regimes, oral care, continence and personal care. Tissue viability, nutritional and moving and handling assessments were also in place. Parklands Nursing Home DS0000019248.V337328.R01.S.doc Version 5.2 Page 12 Actions identified in care plans seen lacked detailed information on how needs should be met and would not allow a new member of staff or agency worker to care appropriately for individuals. In one care plan seen problems relating to tissue damage were identified at the review stage. However, there was no detailing of information on the individual’s progress recorded in further entries in the daily log /evaluation sheet. Evidence of regular weighing and review of skin integrity was not always consistent in files seen. It was noted that room packs had been in existence for three years to record all personal care provided to individuals and participation in daily living activities. These packs were now monitored monthly to ensure proper use and are replaced every thirteen weeks in line with the home’s procedure. It is the practice in the home that individuals’ blood pressure readings, temperature and pulse rates are recorded six monthly. However, some service users were having their vital signs monitored weekly by the request of the general practitioner. All service users were registered with a general practitioner and records were maintained in individuals’ files recording when visits were made and the outcomes. The home employs a physiotherapist to promote service users’ mobility and to help reduce the risk of falls. A chiropodist visits the home regularly. Dental and optical checks are carried out when required. Access to other health care provisions can be made via the general practitioner. It was noted that the home was working closely with the local hospice to provide palliative care to an individual. At the time of the inspection visit there was one service user who was being cared for in bed. The individual looked comfortable and was confident that ‘staff were doing all that they can to ensure all identified needs were being met’. There was a turning chart in place, which staff were maintaining satisfactorily. The home uses a monitored dose system. The medication administration record (MAR) sheets were examined and several unexplained gaps were noted. There was no record of the receipt of medication recorded. Handwritten entries recorded on the MAR sheets were not signed, checked or countersigned to ensure sure that they were correct. Scribbled over signatures were noted, which made it look like medication was signed for before it was offered. Staff practice was not consistent when using the code if medication was not required. Not all staff were recording the pulse rate on the MAR sheet when administering Digoxin medication. There was some confusion in place relating to Nitrazepam medication, which is a sedative and the home as a good practice was treating as a controlled medication. Staff had stopped adopting the good practice but were still storing the medication in the controlled drug cupboard. Parklands Nursing Home DS0000019248.V337328.R01.S.doc Version 5.2 Page 13 This was passed on to the manager to be addressed. This practice and the lack of adequate recording have the potential to put service users at risk. A requirement is made to ensure that all trained staff administer, handle and record medication appropriately. It was noted on some individuals’ MAR sheets medication instructions were written ‘ GIVE AS DIRECTED’. This practice is not safe and should be reviewed. Best practice guidelines states that medication to be administered should specify the strength, dosage, timing and frequency of administration. The practice of receiving instructions by telephone for Warfarin medication should be reviewed. Best practice guidelines states that where changes to the dose of medication are considered necessary, the use of information technology such as fax or e-mail is the preferred method. It is recommended that the home sets up a written protocol for the recording of messages by designated staff and it is kept under review. Service users spoken to were confident that staff respected their privacy and dignity when providing personal care. Individuals’ preferred term of address was recorded in care plans examined. Staff were observed interacting sensitively with service users and personal care was provided in private. A relative raised a concern during the inspection regarding the standard of personal clothing. There have been occasions when personal clothing had not been ironed appropriately. This was passed on to the nurse manager to be addressed. On the day of the inspection service users looked well presented with jewellery and attention to detail. Five visitors were spoken to during the inspection and all were very happy with the overall standard of care. One visitor said “The care in this home is the best.” Additional comments noted in comment cards were “I would like other potential carers out there to come here to Parklands on an observation period.” Parklands Nursing Home DS0000019248.V337328.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 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are in place for people who use the service to be consulted about their particular interests, hobbies and pastimes to ensure that the lifestyle experienced in the home matches their expectations and satisfies their cultural and spiritual needs. EVIDENCE: A requirement was made at the previous inspection for service users’ particular interests, hobbies and pastimes to be included in care plans to ensure that activities provided meet individuals’ needs and are appropriate. The home manager confirmed that some service users were consulted about their preferred activity choice. For those service users who were not able to express their views relatives were contacted to assist in completing individuals’ activity profiles but not all relatives had responded to the home’s request. The home’s general manager said that the home had improved the range and frequency of activities, which were now being provided twice daily. She was particularly pleased to report that one of the housekeeping staff had volunteered to facilitate the weekly bingo sessions, which were proving very Parklands Nursing Home DS0000019248.V337328.R01.S.doc Version 5.2 Page 15 popular. She was confident that the activities that the home was now providing were being tailored to meet service users’ needs. A reminiscence therapist visits every fortnight. A record is kept of all activities provided and it is the expectation of senior managers that all staff facilitate with the activity programme. Further monitoring is needed to ensure that staff maintain the activity record and display board to ensure that all activities provided are recorded with the appropriate date. Two visitors spoken to during the inspection commented on the improvement of the activity programme. One said “I enjoyed participating in the quiz this morning.” Another said “ I visit once a week and every time I visit the staff are always facilitating activities, which the residents enjoy.” Visitors spoken to during the inspection said that the home does not have any restrictions on visiting. They are able to visit at anytime and the home’s staff always make them feel welcome and offer refreshments. It was noted that a hairdresser visits the home weekly. Service users spoken to said that they look forward to her visiting. A vicar visits the home and offers communion to those who wish to be supported with their spiritual needs. Service users are made aware that they can bring in their personal belongings to maximise personal autonomy and choice. There were no service users managing their own finances, either due to choice or infirmity. Lunch was observed which consisted of a choice of chicken pie, cheese flan, boiled potatoes and vegetables. Milk pudding or fresh fruit salad was available for dessert. Service users said that the food provided was always tasty. They also stated that an alternative choice would be provided if they did not like what was on offer. Relatives who completed comment cards were complimentary about the provision of food and catering standards. The following comments were noted: “The standard of food is high.” “The home provides a good variety of food.” “The home’s catering and housekeeping standards are excellent.” Parklands Nursing Home DS0000019248.V337328.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 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home has a complaints procedure to ensure that people who use the service can express their concerns. Staff’s knowledge on the home’s whistle blowing policy need to be further enhanced. EVIDENCE: Information submitted in the home’s annual quality assurance audit (AQAA) indicated that since the last inspection the home had not received any complaints. The Commission had received one verbal complaint about the service since the last inspection. The complaint was referred back to the home to be addressed. It is judged that the regulation in relation to the complaint has been met by the provider. It was noted that the home has a complaints record folder to ensure that all complaints made were being recorded. Relatives who completed comment cards said they were aware o f the home’s complaints procedure and that the home ‘usually’ responded appropriately if concerns were raised. The following comments were noted: “Issues are resolved if I mention it to the staff.” “We do not get any results.” Relatives’ comments were discussed with the management team during the inspection. The home notified the Commission that it had made a referral to the local safeguarding vulnerable adult team. At the time of the inspection the investigation of the incident had not been concluded. Parklands Nursing Home DS0000019248.V337328.R01.S.doc Version 5.2 Page 17 The staff-training matrix seen reflected that all staff had undertaken up to date training on the protection of vulnerable adults. Staff spoken to during the inspection confirmed that they had undertaken training and were able to demonstrate their knowledge on the different types of abuse. However, their knowledge on the home’s whistle blowing policy was not so sound. There was written evidence seen, which indicated that nearly all staff had been issued with a copy of the home’s adult protection and whistle blowing policy. A recommendation is made to ensure that all staff are fully aware of the policy so that they can implement it confidently to protect people using the service. Parklands Nursing Home DS0000019248.V337328.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 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The design and layout of the home meet people who use the service needs. However, scheduled planned maintenance work would need to be fully completed to enable people who use the service to live in a safe, comfortable and well-maintained environment. EVIDENCE: The home’s AQAA reflected that its planned improvement programme to upgrade individuals’ bathrooms and replace bedroom furniture was going as scheduled. The general manager confirmed that since the last inspection four showers a month had been replaced. Some beds and mattresses had been replaced and new equipment purchased to maximise service users’ independence. The fire service department recently inspected the home and the general manager confirmed that the requirements made had been acted on. Parklands Nursing Home DS0000019248.V337328.R01.S.doc Version 5.2 Page 19 The communal bathroom and shower room seen were in a satisfactorily condition. It was noted that the cover on the clinical waste disposal bin in the assisted bathroom was broken and needed to be replaced. A requirement has been made to replace it. Bedrooms seen were clean and tidy and contained service users’ personal possessions such as family photographs and mementoes. Service users spoken to said that they liked they bedrooms and the home was clean and fresh and free from odours. There was evidence to indicate that wash hand basins in those bedrooms that have not been fitted with restrictor valves were being checked weekly and temperatures were being recorded. In one particular bedroom there was an odour. The housekeeping staff were shampooing and cleaning the room daily but the odour was still persisting. This was discussed with the general manager and it was felt that this maybe due to problems with the infrastructure relating to underground pipes. A feasibility study was being arranged. It was suggested that any obstacles to prevent the maintenance plans from progressing should be communicated to the Commission promptly. The laundry room was situated away from where food was being prepared and served. The walls and floor were in satisfactory order and adequate hand washing facilities were available. The sluice area was in a satisfactorily condition. The home’s training matrix indicated that all staff had undertaken updated training in the prevention of cross infection. One staff member was observed wearing gloves when assisting residents with transfers from armchairs to wheelchairs and was discretely told by a colleague to remove them. It was noted that a considerable number of service users were being hoisted and slings were being shared. It is recommended that the home reviews this practice and complies with the department of health infection control guidance by ensuring that slings are laundered regularly in the hottest wash cycle allowable and not shared between service users. Parklands Nursing Home DS0000019248.V337328.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 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home ensures that people who use the service are cared for and supported by staff in sufficient numbers who are trained skill and appropriately vetted to meet their diverse needs. EVIDENCE: The home employs a multicultural staff team. On the day of the inspection there were five care staff on duty and two trained nurses. In addition there were two catering staff on duty and two housekeeping staff The nurse manager was supernumerary to the rota. The home was actively ensuring that the requirement made to have the home staffed with five carers and a trained nurse on the moring shift was being complied with. The nurse manager stated that there had been some rare occasions when the number of care staff on duty had been reduced to four because of staff sickness and the home had found it impossible to find a replacement. Because the home was not fully occupied, she felt that the home was operating within adequate staffing levels and service users were not at risk. Comments received from relatvies’ surveys about staff’s skills and experience were variable. The following comments were noted: “The nurses in particular at Parklands are wonderful and caring.” “I feel more training in the use of hearing aids (fitting), residents own equipment riser chairs, wheelchairs could Parklands Nursing Home DS0000019248.V337328.R01.S.doc Version 5.2 Page 21 be beneficial to residents and relatives. On many occasions my mother’s hearing aid is not fitted in ear correctly inhibiting any hearing she should be getting.” “Yes care staff here carry out their duties with quiet professional efficiency.”. It was noted that 25 if the care staff had achieved the national vocational qualification (NVQ) at level 2 in direct care and 26 were currently working to achieve it. Since the last inspection the home had not recruited any new staff. However, interviews were recently held and some new staff were appointed. The home was ensuring that all new staff undertake the appropriate employments checks before commencing employment. Evidence was seen to this effect. The home had applied for references and PoVA first checks and were waiting on the required documentation. Checks on some staff’s files currently employed were carried out and it is pleasing to report that files examined contained all the information required under Schedule 2 of the Care Homes Regulations 2001 and the National Minimum Standards. One file did not have a recent photograph of the individual to confirm proof of the person’s identity. The general manager agreed to obtain one. The management team has been proactive by ensuring that all staff undertake up to date mandatory training. The training matrix seen indicated that manadatory training for all staff was up to date. Those staff whose training was not up to date had been taken off the rota. Parklands Nursing Home DS0000019248.V337328.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 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home ensures that the management and administration of the home is based on openness. There is effective quality assurance and health and safety checks in place to protect people who use the service safety and welfare. EVIDENCE: The home has a nurse manager who has experience of nursing older people. The Commission was currently processing her application for registration. The management team had worked hard to ensure that regular staff meetings were being held but attendance at meetings have not been high although staff were being paid to attend meetings. The home ensures that minutes of meetings are published and non-attendees are encouraged to read them. Parklands Nursing Home DS0000019248.V337328.R01.S.doc Version 5.2 Page 23 Staff confirmed that supervision sessions had started but the process was not fully developed. It is pleasing to report that the requirement to produce an annual development had been complied with based on a systematic cycle of planning, action and review reflecting outcomes for service users. The home had recently undertaken a quality assurance exercise and the general manager was taking a proactive approach by ensuring that weaknesses highlighted in the findings were being strengthened. Reports relating to monthly regulation 26 visits were available in the home. It is pleasing to report that service users’ monies were available for inspection. Personal allowances were not pooled and individual records and receipts were kept in secured facilities. Records were checked and tallied with money held in the safe. Information submitted in the home’s AQAA reflected that all equipment used in the home was regularly serviced. It is pleasing to report that the air vent in the boiler room had been replaced and the gas safety certificate had been issued. The fire records indicated that the fire panel was being checked weekly. It was noted that since the beginning of the year three fire drills had taken place and all staff had undertaken updated fire training. The home ‘s fire safety building risk assessment had been recently updated. The means of escape from the building and the emergency lighting were being checked frequently. The home has developed a health and safety system to ensure that all health and safety matters are monitored monthly. The general manager carries out these checks and areas requiring attention were being addressed immediately. The nurse manager carries out monthly audits on accidents sustained by service users, however there has not been any specific patterns to falls highlighted. Parklands Nursing Home DS0000019248.V337328.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 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 Score X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No 7 2 8 3 9 2 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 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 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 3 Parklands Nursing Home DS0000019248.V337328.R01.S.doc Version 5.2 Page 25 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 OP7 Regulation 15(1) Requirement Timescale for action 31/08/07 2 OP9 13(2) 3 OP19 16(2)(k) People using the service must have a detailed care plan. Any identified problems must be evaluated to ensure that care provided is person centred. When medication is administered 31/08/07 to people who use the service it must be clearly recorded to ensure that people receive the correct levels of medication The broken clinical waste bin in 21/07/07 the assisted bathroom must be replaced to prevent the spread of infection and to protect people who use the service health. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations Staff’s practice should be consistent to ensure that people who use the service weight and tissue viability assessment are reviewed monthly. DS0000019248.V337328.R01.S.doc Version 5.2 Page 26 Parklands Nursing Home 2. OP9 3. OP9 4. 5. OP9 OP9 6. 7. OP18 OP19 8. OP26 The home’s current system in place when amending people who use the service warfarin dosage should be reviewed to ensure that verbal request of change is followed up by written confirmation. Handwritten entries on medication administration record sheets should be witnessed by a second member of staff to ensure that people who use the service safety is protected. There should be a clear audit trail of all medication received in the home to protect people who use the service from any potential risk of harm. Staff who are responsible for administering medication to people who use the service should have their competencies assessed to ensure that they are proficient in carrying out the task. All staff should be aware of the home’s whistle blowing policy to ensure that they can implement it confidently to protect people using the service. The home should inform the Commission of any obstacles to prevent the maintenance plans from progressing to ensure that people using the service safety is not compromised. The home should comply with the department of health infection control guidance by ensuring that slings are laundered regularly in the hottest wash cycle allowable and not shared to prevent any risk of cross infection to people who use the service. Parklands Nursing Home DS0000019248.V337328.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Nursing Home DS0000019248.V337328.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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