Inspection on 23/12/05 for Parklands Nursing Home

This inspection was carried out on 23rd December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Parklands Nursing Home 11/06/07

Parklands Nursing Home 12/01/07

Parklands Nursing Home 10/05/06

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 Chris Sidwell Unannounced Inspection 23rd December 2005 14.00h 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 DS0000019248.V275059.R01.S.doc Version 5.1 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. DS0000019248.V275059.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Parklands Nursing Home Address 33 Newport Road Woolstone Milton Keynes Buckinghamshire MK15 0AA 01908 692690 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) manager@pnh.demon.co.uk 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 DS0000019248.V275059.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th July 2005 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 Woolstones 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. Woolstones is within walking distance or a very short car or taxi journey of Milton Keynes. The main part of the building is of an older construction and houses the homes large kitchen. The administration offices are situated on the first floor of the older part of the home. Service users bedrooms and communal areas are situated on the north and south wings, which meet to form a large communal dining room and lounge at the rear of the main house. The north and south wings were added to Parklands when it was first opened, some sixteen years ago. Parklands has twenty-two single bedrooms. There are four shared rooms and some of these at the time of the inspection, were being used as single room accommodation. All bedrooms are fitted with adjacent en-suite facilities. As the service users accommodation is built on one level there is no passenger lift. The lounge/dining room is fitted with four sets of French doors, which offer immediate access to the patio area and grounds beyond. A quiet room has recently been created in the sun lounge/conservatory area of the home, adjacent to the lounge. Extensive welltended gardens surround. DS0000019248.V275059.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the report of an unannounced inspection, which took place on the 23rd December 2005. The purpose of the inspection was twofold, to assess whether service users were warm enough, as The Commission for Social Care Inspection had received an anonymous call to say that the central heating had broken down, and to assess compliance with the requirements which were made at the previous inspection undertaken on the 4th and 7th July 2005. The core standards, as identified by the Commission for Social Care Inspection, were inspected at the last inspection and this report should be read in conjunction with that report. Recruitment files and other records were examined. A short tour of the building and the kitchens was undertaken. The administrative manager and a number of care staff who were on duty at the time were spoken to. A number of residents were spoken to. What the service does well: What has improved since the last inspection? What they could do better: The home’s central heating must be repaired. Although additional space heaters have been hired they pose a risk to residents and must only be used for a short period. Thermostatically controlled vales must be fitted to water outlets to which service users have access, beginning with all showers and baths. The fire safety checks must be undertaken regularly. The kitchen must be deep cleaned and the temperatures of the refrigerators be taken regularly. The food thermometer probe must be repaired. DS0000019248.V275059.R01.S.doc Version 5.1 Page 6 The homes recruitment procedures must be reviewed and the proprietor must ensure that all the relevant documentation is available in staff recruitment files before they start work. A permanent manager who registers with The Commission for Social Care Inspection must be appointed. The proprietor must undertake regular quality assurance visits and supply the Commission for Social Care Inspection with reports describing the outcome of these visits. The proprietor must also ensure that relevant notifications of adverse events are made to the Commission for Social Care Inspection in a timely manner. 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. DS0000019248.V275059.R01.S.doc Version 5.1 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 DS0000019248.V275059.R01.S.doc Version 5.1 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): These standards were not assessed at this inspection but were met at the inspection undertaken on 4th and 7th July 2005. EVIDENCE: DS0000019248.V275059.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed at this inspection but were met at the inspection undertaken on 4th and 7th July 2005. EVIDENCE: DS0000019248.V275059.R01.S.doc Version 5.1 Page 10 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): These standards were not assessed at this inspection but were met or almost at the inspection undertaken on 4th and 7th July 2005. EVIDENCE: DS0000019248.V275059.R01.S.doc Version 5.1 Page 11 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): These standards were not assessed at this inspection but were met or almost met at the inspection undertaken on 4th and 7th July 2005. EVIDENCE: DS0000019248.V275059.R01.S.doc Version 5.1 Page 12 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): 25 The heating systems do not at present meet residents’ needs and their safety is compromised by the lack of thermostatically controlled water outlet valves and radiator covers. EVIDENCE: On the day of the inspection, the main central heating boiler had broken down and consequently there was no heating to the home. The home had hot water. The administrative manager had hired large space heaters for the communal areas and electric heaters for service users’ bedrooms. The room temperatures were as follows;- dining room, 24C, lounge, 25C, corridor 25C. The temperature of a number of resident’s bedrooms was checked and found to be in the region of 23C. The service users spoken to said that they were warm enough. The space heaters were very hot to touch and posed a risk to mobile residents. The administrative manager on duty at the time said that residents were being supervised until the heating was repaired. The administrative manager has obtained a number of quotes for the repair of the heating and is hoping to have it repaired by the 16th January 2005. The DS0000019248.V275059.R01.S.doc Version 5.1 Page 13 Commission for Social Care Inspection had not been notified of the heating failure, as is required by the Care Homes Regulations 2001 and guidance was left with the administrative manager as to the notifications which should be made to the Commission for Social Care Inspection. No notifications had been received since the 5th August 2005 The radiators in residents’ rooms do not have low temperature surfaces and not all are covered. This has been a requirement of previous reports and has not yet been complied with. It was not possible to test the surface temperature as the heating was not on. The administrative manager said that the water outlets did not have thermostatically controlled valves. These valves should be fitted to ensure that residents are not at risk of scalds. The water outlet temperatures of two rooms were tested. The temperature at the hand basins was 52C and at the showers 43C. The proprietor must ensure that thermostatically controlled valves are fitted to all showers and baths as a matter of urgency and that thermostatically controlled valves are subsequently fitted to all hand basins. Residents’ rooms have natural light and the lighting is domestic in character. Emergency lighting is provided in the home. DS0000019248.V275059.R01.S.doc Version 5.1 Page 14 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): 29 The recruitment procedures do not fully protect residents from potentially unsuitable care workers. EVIDENCE: The recruitment files of four staff members were examined. None contained the full set of required documentation. The staff members’ start date was not always on file. Only two of the four files had evidence that a Criminal Records Bureau check had been undertaken by Parklands prior to the staff member starting work. Two references had been taken up for all four members of staff, although neither of one staff member’s references were from his previous employer. The administrative manager had neither a contract nor a job description. She said that there was some uncertainty as to her role. Not all staff had evidence on file that they hold a valid work permit. Requirements have been made at previous inspections that recruitment procedures be improved. These requirements will be repeated in this inspection report and an additional visit will be undertaken to assess compliance. DS0000019248.V275059.R01.S.doc Version 5.1 Page 15 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, 37 and 38 A permanent manager must be appointed if the quality of care for residents is to be maintained and staff are to be given effective leadership. The lack of systematic quality assurance visits by the provider does not help to ensure that the quality of care received by residents is of a consistently high standard. The fire safety procedures must be improved if residents are to be fully protected. The kitchen hygiene and record keeping must be improved if resident’s are not to be potentially at risk. EVIDENCE: The home does not have a registered manager at present. The post has been vacant for over six months and an interim structure has been agreed whereby two experienced nurses manage the care aspects of the home and a newly DS0000019248.V275059.R01.S.doc Version 5.1 Page 16 appointed administrative manager manages all administrative affairs. This has been satisfactory for a short period but is not sustainable in the long term and a manager must be appointed. He/she should subsequently register with The Commission for Social Care Inspection. The registered provider does not make regular quality assurance visits to the home, nor does the registered provider supply a copy of the reports of such visits to the Commission for Social Care Inspection. The last report sent to the Commission for Social Care Inspection was received on the 3rd January 2004. This has also been a requirement of previous reports, which has not yet been complied with. Guidance was left with the administrative manager as to the requirement and suggested formats that the report could take. The requirements arising from previous inspections have not been complied with in a timely manner. Generic risk assessments have been now been undertaken. These should be reviewed regularly. The administrative manager said that the requirements and the recommendations arising from the last fire officer’s visit had been implemented. A fire risk assessment had been undertaken in June 2005. The last fire drill recorded was in June 2005. The weekly test of fire alarms had not been undertaken since August 2005. The staff spoken to were aware of the fire evacuation procedures. The kitchen was visited. Records of refrigerator temperatures had been checked and recorded although the probe was found not to be working on the day of the inspection. Food temperature check records were completed although the same probe is used. This needs to be addressed and separate refrigerator thermometers purchased and the food probe repaired. The work surfaces in the kitchen were clean although some of the ledges were dusty and must be cleaned. The administrative manager was uncertain as to when the kitchen was last deep cleaned. DS0000019248.V275059.R01.S.doc Version 5.1 Page 17 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x X X X X X X 1 X STAFFING Standard No Score 27 X 28 X 29 1 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 1 X X X 1 1 DS0000019248.V275059.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? Yes 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 2 Standard OP25 OP25 Regulation 23 13 Requirement The central heating must be repaired All radiators to which service users have access must have low surface temperatures or be protected by covers. This is an unmet requirement of previous inspections and a new timescale has been set. Thermostatically controlled water valves must be fitted to all showers and baths Risk assessments must be undertaken for all service users to determine their level of risk from scalding where thermostatically controlled valves are not provided to wash hand basins. A programme to fit these valves in service users’ bedrooms should be agreed with the Commission for Social Care Inspection, starting with those service users most at risk. The proprietor must ensure that the recruitment files of all employees contain the information specified in Regulation 19 and schedule 2 DS0000019248.V275059.R01.S.doc Timescale for action 31/01/06 28/02/06 3 4 OP25 OP25 13 13 28/02/06 28/02/06 5 OP29 19 28/02/06 Version 5.1 Page 19 6 OP29 19 7 8 OP31 OP33 8 26 10 OP37 37 11 OP38 12 and 23 12 OP38 12 13 OP38 12 and 4 of the Care Homes Regulations 2001. This is an unmet requirement of previous inspections and a new timescale has been set. The proprietor must ensure that he has a copy of a valid work permit on file for all relevant staff A permanent manager, who has the necessary skills and knowledge, must be appointed. It is required that the proprietor records his visits to the home in line with Regulation 26 of the Care Homes Regulations 2001 and that copies of the reports are supplied to the Aylesbury office of the Commission for Social care Inspection. This is an unmet requirement of previous inspections and a new timescale has been set. The Commission for Social Care Inspection must be notified of adverse events in line with Regulation 37 of the Care Homes Regulations 2001. The proprietor should ensure that regular fire drills are undertaken and that the fire alarms are tested weekly and recorded. This is an unmet requirement of previous inspections and a new timescale has been set. The proprietor must ensure that accurate refrigerator temperatures are recorded and that the temperature of food is measured before it is served. The kitchen must be deep cleaned. 28/02/06 28/02/06 31/03/06 31/01/06 28/02/06 28/02/06 28/02/06 DS0000019248.V275059.R01.S.doc Version 5.1 Page 20 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000019248.V275059.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000019248.V275059.R01.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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