Inspection on 04/07/05 for Parklands Nursing Home

This inspection was carried out on 4th July 2005.

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 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 23/12/05

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 33 Newport Road Woolstone Milton Keynes Buckinghamshire, MK15 0AA Lead Inspector Moira Jones Announced 04July 2005 09:30am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Parklands Version 1.10 Page 3 SERVICE INFORMATION Name of service Parklands Nursing Home Address 33 Newport Road, Woolstone, Milton Keynes, Buckinghamshire, MK15 0AA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01908692690 Mr Vaz Mrs M Officer Mrs Nicola Kelly Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Parklands Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 27th September 2004 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 the new twon of Milton Keynes. There is some public transport but services to this part of Milton Keynes are infrequent. The main part of the building is of an older construction and houses the home’s 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 well tended gardens surround. Parklands Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection of Parklands, a privately owned home registered to provide care with nursing for up to thirty older service users was conducted over two days during July 2005. The inspection consisted of a tour of the building, discussion with the manager and the assessment of a variety of substantiating documentation. Service users and staff were met with and general discussions about the care and support received ensued. The opportunity was also presented to meet with some of the visitors to the home. Twenty-four comment cards were received in response to this inspection, one from a general practitioner, six from relatives/visitors and seventeen from service users. The comments made about the home and the care and support given to service users were generally positive although some issues presented, which are discussed within the narrative of the report. The issue of ant infestation was raised on one comment card and this is discussed further in the section entitled ‘Management and Administration’. This inspection was the first announced inspection to take place at Parklands since the current manager was registered by the Commission for Social Care Inspection. Parklands has not recently benefited from positive inspection reports and there have been several changes of managers. At the time of the last unannounced inspection of the home it was noted that improvements had been made to the general service delivery and it was further noted throughout the course of this inspection that the improvements made had continued and the manager and wider staff team are to be commended for their initiative and commitment. The manager had met all the requirements and recommendations that were issued further to the last unannounced inspection of the home that fell within her circle of influence. It was a pity however, that the proprietor had failed to meet the single requirement that was his prerogative to meet. This is outlined within the report in the section marked ‘Management and Administration’. There were clearly perceived improvements to the quality of service users’ care provision. The staff training initiative nurtured by the manager is exemplary and service users care now benefits from well-informed staff who have a good approach and attitude to care. However, the manager still needs to formally plan a staff development plan to ensure that training continues to meet the home’s needs. There was a clear improvement in staff’s personnel files. They are now far more ordered with a robust approach to ensuring that all legislative clearances are obtained prior to employment. It was a pity however, that the proprietor failed to work in line with the manager’s example and introduced a new staff member to the team without the prescribed recruitment route being followed. This issue is outlined within the body of the report in the section marked ‘Staffing’. Plans are in place for environmental improvements to the home with clear evidence of already seen of the work completed, to date. Staff are Parklands Version 1.10 Page 6 commended for their continued efforts to ensure that the home is clean and tidy, which cannot be easy considering that parts of the home, specifically the en-suite facilities, are showing signs of adverse wear and tear. Some work is required to ensure that risk assessments are current. Health and safety is however, generally well managed. Overall, there has been an immense improvement to the standards of care and service at Parklands, which can in no small way be attributed to a manager who is focused, forward thinking, has high personal and professional standards and expectations and has clear leadership and organisational skills. Well done to the whole staff team for promoting the quality standards of the home in such a positive manner. However, there is still some way to go before the home can truly achieve the ‘Excellence in care’ it strives for. Given the progress to date, there is no reason why this cannot be achieved. What the service does well: What has improved since the last inspection? The contents of the statement of purpose and service users guide. ‘Service User Nursing Support Profiles’ outline needs more clearly. Staff are inducted to their posts. The policies and procedures that support the management of comments and complaints are robust. Comments and complaints are thoroughly investigated and responded to appropriately and effectively. Vulnerable service users are now more effectively protected. The home now has an effective recruitment process. The number of agency staff employed at the home is reduced. A more robust approach has been applied to the staff training initiative. The manager has developed a tool for eliciting service user, staff and stakeholder opinion of the service on an annual basis. Parklands Version 1.10 Page 7 Staff feel valued and supported in their roles. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Parklands Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Parklands Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 5 and 6 The home has developed a statement of purpose and service users guide therefore providing service users with information that will aid them in the decision making process about where they wish to live. Each service user is issued with a contract/terms and conditions of occupancy, which outlines their rights as residents of the home and also makes them aware of any restrictions to their freedom and access to services. Individual needs are assessed prior to admission, ensuring that staff have a good knowledge of service users requirements therefore enabling them to meet those needs more efficiently. All service users are admitted into the home with a view to permanency, enabling them to ‘test’ the suitability of the home in line with their needs prior to deciding whether they wish to be admitted on a permanent basis. EVIDENCE: The manager has re-written the home’s statement of purpose and has précised the information presented on this document and has also re-written the service Parklands Version 1.10 Page 10 users guide. Both documents were assessed and found to fully comply with the standards of the Care Standards Act 2000. All service users are provided with a contract, which outlines the main terms and conditions of occupancy and highlights any restrictions to their freedom and access to services. The contracts have recently been revised, bringing them in line with the criteria outlined within standard 2 of the National Minimum Standards for Care Homes for Older people. All admissions into the home are made in line with the home’s admission policy and procedure. The manager assesses the needs of all new service users prior to their admission into the home. During the time under review two service users have been discharged from the home and nine service users have been admitted. Completed needs assessments for the service users admitted into the home during the time under review were seen. The information gathered and recorded on the pro forma correlated with the requirements of the standard and was followed through to the service users plans, which will be discussed in the section entitled ‘Health and personal Care’. Recording was found to be excellent and gave a thorough outline of needs, assessing them to be low, medium or high. All service users are admitted into the home with a view to permanency. ‘Trial’ stays at the home are initially for four weeks, at the end of which there is a formal review to agree permanency. However, the manager described admission into the home as ‘being tempered to individual need’, which sometimes means that the ‘trial’ stay is in excess of four weeks. Service users, their relatives and/or representatives, named nurse, key worker, manager and health care professionals are included in the review to agree permanency, or to agree a care package that is further tempered to need. Service users needs are formally reviewed at least on an annual basis but can be reviewed more often, as required. Notes of the reviews that take place are maintained on service users’ individual files. Reviews appeared to be generally up to date. Once service users are admitted into the home the continuing care team reviews their needs after one week, then after six weeks and thereafter every six months. In order to fully meet the needs of service users the home is able to access a wide range of therapists who are based at Milton Keynes Hospital and community based practices via the general practitioner. Respite provision is available at the home as vacancies allow. Approximately two respite admissions have been made into the home during the past eight months. The needs of people requiring respite care are assessed using the same pro forma to record information as that of people requiring to be admitted to the home on a permanent basis. No intermediate/rehabilitative care is provided at Parklands. Parklands Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 and 11 Individual needs are outlined within ‘Service User Nursing Support Profiles’, ensuring that requirements are well known to staff who are able to provide care and support as assessed. The home’s approach and attitude towards healthcare provision means that this aspect of service users needs are conscientiously met. There are robust medication procedures in place to ensure that service users medications are appropriately administered and securely stored. Staff are inducted to their posts and educated to apply the core values to all aspects of their work, ensuring that service users rights are protected and promoted. Although palliative care training has yet to be arranged, service users benefit from the support of staff who are sympathetic to their individual situations. EVIDENCE: Parklands Version 1.10 Page 12 Service users needs are outlined within individual ‘Service User Nursing Support Profile’, which are based on information gathered during the assessment of service user’s needs prior to admission and the changing needs of service users once admitted into the home. The profiles included all key information about service users such as their preferred name, date of birth, next of kin, religion/beliefs and medical practitioner etc. There was also evidence of healthcare referrals and intervention to therapists in line with assessed needs. The recording of information on the profiles was concise with some gaps evident but the documents were clearly ‘works in progress’ and are continually changing to remain reflective of service users needs. The recording of information on the daily records, maintained by staff and used to record all interventions and activities of daily living was noted to be thorough and informative and was evident of the effectiveness of staff’s recent training in recording practices. Language used within the narratives was noted to be appropriate. Profiles are subject to monthly reviews and are updated accordingly. Waterlow pressure sore assessments, which are underpinned by a prevention and treatment policy, are undertaken as well as monthly reviews of the nutrition screening assessments. There are moving and handling care plans and substantiating risk assessments, which had been thoroughly undertaken and benefited from considered control measures. Risk assessments that were based on the perceived vulnerabilities of service users, including the use of cot sides, were in place, were noted to be thorough and again included considered control measures. They were assessed as being subject to regular reviews and were therefore, as far as can be ascertained, inclusive of current information. Service user’s NHS entitlements are ensured as evidenced via the recording of healthcare appointment attended and any required interventions. At the time of this announced inspection all service users were registered at Milton Keynes Village Practice, although they are enabled to retain their own doctor. The doctor holds a surgery at the home every Tuesday and consults with service users in the privacy of their individual bedrooms, therefore ensuring that privacy and dignity is promoted and maintained. Service users’ medications are reviewed by the doctor on an ongoing basis. One of the comment cards returned in response to this announced inspection was from a healthcare professional who indicated that the home manages service users’ health care needs appropriately and with due reference to specialist advice. The manager reported a very good level of support from the doctor and service users and staff also spoke highly of him. The tissue viability nurse visits the home as required and, at the time of this inspection, advice was being sought to ensure that the care and support required to specifically manage a clinical situation did not develop into a tissue viability issue. There were no tissue viability issues at Parklands at the time of this inspection. Tissue viability is further promoted via nutritional screening. The dietician visits the home as and when required and menus are planned so that nutrition and therefore tissue viability is not compromised. All initiatives are recorded. Service users receive routine dental checks, at prescribed intervals. The dentist visits the home on a domiciliary basis and undertakes routine checks Parklands Version 1.10 Page 13 and as much remedial work as possible at the home but one service user does visit the practice, which is based at Eaglestone, close to Milton Keynes General Hospital. Audio tests, by the audiologists based at Milton Keynes Hospital are arranged to take place at the home and routine maintenance of hearing aids such as replacing batteries and re-tubing is undertaken by staff. Although there were no obvious outstanding occupational health referrals at the time of this announced inspection and the manager reported that referrals occur fairly infrequently, from discussions it was ascertained that the manager and senior staff have a good understanding of how to access this service, as need dictates. The community psychiatric nurse and psycho geriatrician visit some service users as part of their ongoing package of care. It would appear that there have recently been some difficulties in accessing the support of a community psychiatric nurse for one service user whose referral was made in February 2005. The manager continues to pursue this matter and has a strategy for making sure that this service users needs are not further compromised. Medications are delivered to the home on a weekly basis from a pharmacy that is situated in the nearby town of Newport Pagnell. There is a medication policy and procedure in place to guide staff in effective administration practices. It is advised that in the section of the policy, which relates to the selfadministration of medications, the need for individual risk assessments to support the activity is outlined. At the time of this announced inspection no service user self-administered their medications. There was clear evidence on file of the audits of medications held within the home that take place every two months. These are undertaken by the supplying pharmacist who records the outcome of the audit with any required or recommended action. All nursing staff are trained to administer medications through in-house facilitation that took place during January and February 2005. The pharmacy that supplies the home with medications is due to update the training for nursing staff in the near future. Medications are received into the home and noted on the medication administration record (MAR) sheets provided by the pharmacy. Medications returned to the pharmacy are noted in a designated file that was inclusive of all required information however, the file did need to be streamlined to bring it up to the same standards as all other documents maintained within the home. The manager was aware of this and was considering the most effective way of ensuring that these records are effective. This particular aspect of the standard that discusses medications will be further assessed at the time of the next inspection of the home. The home maintains a controlled drug register and the number of controlled drugs held within the home, which were minimal, correlated with the number of drugs recorded on the register. Staff countersigns all controlled drugs administered within the home. Perishable medications were found to be stored in a lockable medical ‘fridge. Records of the medical ‘fridge temperatures were maintained (taken twice daily) and found to be within acceptable levels. ‘Mainstream’ medications are held within a secured metal trolley. Stocks were found to be minimal and were within their ‘use by’ dates. Medications Parklands Version 1.10 Page 14 prescribed mid cycle are supported by a pre printed label supplied by the pharmacy, therefore meeting a requirement issued as a result of the last unannounced inspection of the home. All staff are inducted to their various posts and are issued with the staff handbook, which forms a part of the terms and conditions of their employment and includes copies of relevant key policies and procedures. The induction is in line with TOPPs guidelines and outlines the expectation of the home regarding the manner in which service users are to be treated. By virtue of the fact that service users bedrooms generally provide single room accommodation, privacy and dignity is protected. However, should a couple or siblings be admitted into the home and wish to be provided with shared accommodation this need could be met. With the exception of one bedroom en-suite facilities are integral to every bedroom and the bedroom without private facilities is within close proximity to the communal bathroom and toilet. ‘Wet room’ type facilities are currently being fitted to the home. Service users are able to have telephones in their bedrooms and it was ascertained that many do. The use of the telephone is an integral part of the service at Parklands and incurs no charges. Preferred forms of address are noted on the ‘Service User Nursing Support Profile’. No palliative care training has yet taken place at the home although the manager has plans to facilitate this. The manager described staff’s current practices in relation to palliative care as ‘instinctive’ and, although she also described practices as very caring, felt that communication in relation to this specialised area of care was deficient. Changing needs are outlined on individual profiles and all initiatives are discussed with relatives and/or representatives. The manager commented positively on the home’s relationship with the Reverend James and described him as supportive and sensitive. From discussions it would appear that the home would be able to ensure that spiritual needs are met, made easier as the new town of Milton Keynes is very cosmopolitan and reflective of cultural diversity. Service user’s profiles contain a section to record service users future wishes but these are generally not known and are an aspect of the service that requires further development. The manager and staff team are aware of how and where to access specialist health care support and the home was assured the support of Milton Keynes Village Practice and the professionals who are based there. Included on the medication policy is guidance on the management of service user’s medications when they are no longer required. Parklands Version 1.10 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Service users are provided with a good range of activities and are enabled to participate as they wish, ensuring that their social, emotional and spiritual needs are met. Visiting at the home is flexible, which means that service users are able to retain links with the community as well as maintain relationships with relatives and/or representatives. Service users are encouraged to bring their personal possessions with them into the home, which promotes the exercising of personal choice and individuality. The home provides service users with a wide range of home cooked, wholesome meals served within a pleasant environment, ensuring that their nutritional needs as well as their social needs are met. EVIDENCE: The part time activity co-ordinator who was employed to plan and facilitate service users leisure interests has now left the home’s employment and another person has been recruited to continue this initiative. The new coordinator will take up her new post at the end of the summer and, until such Parklands Version 1.10 Page 16 time, current staff are taking responsibility for ensuring that activities take place. It is intended that this will arrangement will continue after the new coordinator has taken up her post to enable a more varied and participative programme of activities. Service users benefit from a range of activities and pastimes that meet their social, emotional and spiritual needs on leisure, recreational and occupational levels. Activity programmes are planned at least two weeks in advance and consist of arts and crafts, sing-a-longs, board games, armchair aerobics, outings to the village of Woolstones and visiting theatre groups who visit the home approximately every three months. Reminiscence therapy is promoted at the home and is facilitated by a person remunerated by the home. Reminiscence therapy is planned to take place every three weeks and the activity programme is planned in line with this and the church services. Key occasions such as Christmas, Easter and harvest festival are also observed as well as birthdays. Local schools, although not regular visitors to Parklands generally visit the home at key times of the year. Two service users attend the ‘Talkback Club’ for people who have suffered strokes and have expressive dysphasia. One service user attends a mainstream day centre for older people. The Reverend James visits the home every week and conducts fortnightly services with communion taking place each month, enabling service users’ spiritual needs to be met. To date, there is little community contact although the home appears to be slowly integrating with the people who live in the village, which is situated within the London commuter belt. However, the home will be participating in the village fete, some of which will be set within Parklands’ grounds. The home promotes ‘open’ visiting, within reasonable timescales. Any restrictions on visiting are identified within the service users guide. Service users are supported by staff to decide whom they wish and do not wish to see and visiting may take place either within the privacy of individual bedrooms or the ‘quiet room’ or the less private lounge. All visitors to the home are naturally screened as they must ring the inner doorbell before being given entry into the home and there is also an expectation that they will indicate on the visitor’s book when they enter and egress the building. The same expectation applies to staff. Service users are able to drink alcohol as their prescribed medications permit and arrangements can be made for any service users who wish to smoke. Staff are prohibited from smoking within the home. Apart from the four service users most recently admitted into the home all are registered on the electoral roll. Arrangements were made for service users to be able to vote at the recent general elections and those who wished to vote, did so. Service users are enabled to bring their personal possessions into the home with them, as per the guidance included on the service users guide. Service users and staff are able to access their personal records. No advocate currently visits the home although the manager has requested that Age Concern do so. It would appear that Age Concern’s limited human resources prohibit them from supporting the home. The manager however, is considering the recruitment of volunteers to visit the home and maybe invite church befrienders to meet service users. Parklands Version 1.10 Page 17 The kitchen manager plans the menus. These proved to be varied yet balanced and comprised of a combination of traditional and contemporary meals. It was reported that the only proviso given to the kitchen manager was to ensure that a mixed grill be served every Wednesday and a roast lunch each Sunday. This had been complied with. On the first day of inspection the lunch was a choice of salmon in parsley sauce or sausage and onion pie with creamed potatoes, peas and (where appropriate), gravy, with fruit jelly and ice cream or apple crumble and custard for pudding. On the second day of inspection lunch was a choice of liver and bacon or minced beef pies, boiled or creamed potatoes, cabbage and gravy with rice pudding with nutmeg or milk jelly for pudding. Although mealtimes are fairly prescriptive there is some flexibility for service users with: • Breakfast served from 7.00am each day. Served either in service users bedrooms or the dining room, porridge, toast and sandwiches with tea, coffee or soft drinks is served before 8.00am. After 8.00am, a cooked breakfast is available on request. • Morning tea with scones, pancakes or doughnuts is served at approximately 10.00am. • Lunch is served at approximately 12.30pm, either in the dining room or in individual bedrooms. • Afternoon tea is served at approximately 5.00pm and consists of a selection of freshly made sandwiches and finger foods or a hot snack if preferred and a selection of home made cakes and fresh fruit. Hot and cold drinks and snacks are available to service users on request but are routinely offered at 10.00am (as outlined above), 2.00pm and 8.30pm. The dietician visits the home as and when required and the home is observant of service users nutritional needs, with weights and tissue viability routinely monitored. Supplementary foods are available via prescription. Specialist diets are catered for and likes, dislikes, preferences and allergies noted on service users plans. No service user currently residing in the home has cultural catering requirements. However, soft, pureed and chopped diets are provided as needs dictate. Approximately seven or eight service users are assisted to eat, either through direct support or prompting. There were clearly enough staff on duty to appropriately and effectively assist service users to eat, the manager having revised staff’s lunchtime roster to accommodate the home’s need. From observations made it was noted that service users were supported discreetly to eat, ensuring that their dignity was not compromised at any time. Specialist eating aids such as plate guards were noted to be in use at the home, which further promoted dignity and independence. Service users generally dine in the dining room, which is conducive to a positive experience. The kitchen manager maintains records of what service users eat and records any variations to the mainstream menu. Parklands Version 1.10 Page 18 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Any comments that have been made known to the home have been responded to appropriately, using the complaints policy and procedure. The complaints policy and procedure, which is made available to service users and stakeholders enables them to have their comments listened to and proactively responded to. Vulnerable service users are protected by means of robust policies and procedures and staff training. EVIDENCE: The home’s complaints policy and procedure have been updated by the manager to fully comply with the requirements as outlined within Regulation 22 of the Care Homes Regulations 2001. During the time under review, four comments have been received by the home. Assessment of the records maintained evidenced that the manager had dealt with all issues appropriately and proportionally. The home has developed a system for recording all comments made. Recording was assessed as being excellent. Any required action by the home was outlined on the pro forma, which also included a written response by the complainant to substantiate their satisfaction with the response of the home. All responses indicated that complainants considered their comments to be well managed and proactively responded to. Several comment cards received indicated that stakeholders were unaware of the complaints policy and procedure however, throughout the course of the inspection it was noted that copies of the guidance were available, albeit discreetly. Parklands Version 1.10 Page 19 The home works in line with the Milton Keynes interagency guideline for the protection of vulnerable adults. All staff who were employed at the home up until October 2004 have been trained in the protection of vulnerable adults and staff who have joined the team since that time were due to attend training in the protection of vulnerable adults on the day after the first day of this announced inspection and again on July 12th. The training is facilitated by Milton Keynes Crossroads and includes POVA training. Dementia care training for staff is due to be facilitated by the manager and senior staff team and will be presented via a cascaded training pack purchased from Mulberry House Ltd, a training consortium. A core dementia care policy has been adopted by the home via Mulberry House Ltd and has been supplemented by the manager. Challenging behaviour is theoretically managed by staff through the ‘Violence and Aggression’ policy, which was developed by the manager in October 2004. Staff training in the management of challenging behaviour is divided into two sessions with the last session taking place during April 2005. At the time of this announced inspection sixteen staff were still in need of being trained in methods of managing challenging behaviour. The manager was in the process of planning the next two sessions. In addition to the above policies, procedures and training there is also a ‘Whistle Blowing’ policy, which forms an integral part of the staff handbook and a ‘Finance’ policy, which is outlined within the General Social Care Council information given to staff and also within the in-house code of conduct, which forms a part of staff’s handbooks and therefore their terms and conditions of employment. Parklands Version 1.10 Page 20 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 Although there are plans to refurbish the home service users are provided with a range of communal and private facilities, which are safe and comfortable. Although there was a slight odour in one bedroom, standards of cleanliness were good, ensuring that service users health and welfare were protected. EVIDENCE: Parklands is a care home with nursing that is registered to provide care and accommodation for up to thirty older service users. There were twenty-five service users in residence at the home on the first day of inspection. The home is situated in the Woolstones area of Milton Keynes. The main part of the home, which is situated at the front of the home and is of an older construction and accommodates the kitchen and administration offices. Service users’ accommodation is situated in a single storey extension that was added to the original part of the house when the home started operating some sixteen years ago. Externally, the home has parking facilities for approximately twelve to fifteen vehicles. At the rear of the home, there are extensive gardens, mainly laid to Parklands Version 1.10 Page 21 lawn and there is a large patio area and communal gardens situated between the north and south wings of the home, accessible via a set of French doors situated in the communal lounge. All parts of the garden were noted to be very well maintained and provided service users with a pleasant and safe environment. Bedrooms are situated on either the north or south wings of the home. Twenty-two bedrooms provide single room accommodation. Four bedrooms provide shared accommodation. Privacy curtains are fitted in shared rooms for when bedrooms are occupied by two people. The tour of the building evidenced that bedrooms have been individualised by service users using their personal possessions. All but one of the bedrooms are fitted with en-suite facilities and the bedroom without private facilities is within very close proximity to the communal bathroom. All beds are assisted to ensure staff’s ability to provide service users with care that is safe and appropriate and service users with comfort. Some beds were fitted with appropriate pressure relieving mattresses. Each bedroom/en-suite facility had liquid soap and paper towels to enable standards of hygiene to be promoted by staff between caring for each service user. There is a large communal lounge and a ‘quiet room’ for service user’s benefit. The home is generally brightly furnished and traditionally decorated with adequate comfortable seating for all service users. The dining room is adjacent to the lounge and provides service users with an environment that is conducive to conversation and a positive dining experience. Some bedroom furniture has recently been replaced and it was evident that some furniture requires replacing in the not too distant future. The home is carpeted throughout and, due to the water damage that emanates from an elderly and inefficient hot water system (which is in the process of being replaced), the carpets in the corridors do require replacing. It is acknowledged that this is planned to take place during the forthcoming planned refurbishment of the home. A requirement issued as a result of the last unannounced inspection regarding the maintenance of the carpet in the dining area of the home had been compiled with. The kitchen is run to HACCP standards. The home is alarmed and security lighting is fitted at key, external points. At the time of this announced inspection the home was noted to be clean and tidy, although there was a slight odour in one bedroom, which was discussed with the manager. Standards of cleanliness are of a good specification and the staff team work well together to achieve and maintain acceptable levels of hygiene. The laundry, which is situated adjacent to the reception area, is fitted with two washing machines and one tumble dryer. The washing machines are fitted with an integral sluicing facility and the home uses alginate bags to segregate infected laundry from other laundry items. Further to the unannounced inspection of the home that was conducted in September 2004, the requirements issued at that time have been met. There is now a service contract in relation to the repair and maintenance of the laundry equipment and the area in front of the hand washing facilities in the laundry were free from obstruction. Parklands Version 1.10 Page 22 Hand washing facilities for all staff using the laundry were evident. Continence is well managed and all clinical waste is subject to a contracted collection service by a nationally recognised provider. There was clear evidence of the refurbishment that has commenced at the home. The boilers fitted in the home have recently been replaced and the network of pipes that provide hot water and heating throughout the home are due to be replaced prior to any refurbishment work commencing. The home is also in the process of installing a wet room to enable easier access to a shower for those frailer service users. Overall, the quality of the environment is relative to the fact that some areas of the home are showing signs of wear and tear through age and constant use. This however, will be considered during the forthcoming refurbishment of the home and in the meantime the environment is being maintained to a good standard, much to staff’s commendation. Parklands Version 1.10 Page 23 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 Established staffing hours were in excess of those recommended by the Residential Forum’s calculation, which means that staff are more than capable of meeting service user’s individual requirements. Effective staff recruitment processes and reduced use of agency staff ensure that service users benefit from staff who are familiar to them and who are able to provide continuity of care. The manager has a clear understanding of the correct and appropriate processes that surround staff recruitment however, if service users are to benefit from staff who are adequately screened prior to commencing employment the proprietor must desist from appointing staff without reference to the manager. A more robust approach has been applied to the staff training initiative, ensuring that service users benefit from staff who are well informed and have an awareness of current care initiatives. EVIDENCE: Although two comment cards suggested that the home was not always adequately staffed, records indicated this not to be the case. From information taken from the pre-inspection questionnaire, the home’s roster and from discussions with staff it was apparent that the home rosters staff in excess two hundred hours more per week than those required in line with the Residential Forum’s calculation. Rosters assessed further confirmed this number and staff Parklands Version 1.10 Page 24 spoken with stated that the staffing levels were comfortable. The manager stated that additional staff can also be brought in, as service users needs dictate. The staffing aim of the home is to roster one nurse and four carers during the course of the waking day, until 8.00pm when the number of carers reduces to two. The manager assumes the role of the second registered nurse on duty. One nurse and two carers provide care and support to service users overnight. The number of agency staff used at the home to cover any gaps in the roster has reduced significantly and the manager has successfully developed a bank of relief staff who are employed by the home and who benefit from the training and development opportunities presented by the home. This provides service users with continuity of care and therefore does not compromise their individuality and standards of support in the same way the use of agency staff may. Staff spoken with stated that they felt the home was adequately covered and that they felt able to meet service users individual needs. No staff under the age of twenty-one are employed at the home and only experienced nurses are left in charge of the home. The cultural ratio of staff to service users is unbalanced although the gender ratio is being addressed as the home now employs several male staff. The manager is supernumerary to the roster and, further to the recent departure of the assistant manager is in the process of re-structuring the team. There are already housekeeping and kitchen managers in place and two staff members who are already employed at the home as registered nurses have been promoted to assistant managers. One assistant manager will concentrate more on clinical issues while the other assistant manager will be more involved with staff training. The assistant managers will each have a team of staff they are responsible for line managing. The housekeeping manager has responsibility for line managing one full time and two part time housekeepers. The kitchen manager is also the home’s cook and line manages two part time kitchen assistants. The efficiency of the re-structuring will be further assessed at the next inspection of the home but there is no reason to believe that it will not be effective, given the planning and the preparations made by the manager and wider staff team. For the purposes of NVQ the home is registered with the Care Council, who provide an assessor to evaluate and set work for candidates. At the time of this announced inspection eight carers were registered to commence the Level 2 award. Two carers have already completed Level 2 and are registered to undertake Level 3. The manager is in the process of completing the Registered Manager’s Award and the newly promoted assistant managers have an interest in qualifying to A1 standards, which means that they will be qualified to assess and set work for candidates. This means that the home has made good progress towards ensuring it complies with the need for 50 of its workforce to be trained in NVQ standards. Progress will be further assessed at the next inspection when it is expected that those registered will have either completed or almost completed their awards. Parklands Version 1.10 Page 25 No trainees were attending the home at the time of this announced inspection but the facilitation of student nurses may be a future consideration. Six staff, including the assistant manager, have left the home’s employment since September 2005 when the home was last inspected. At that time the home carried several vacancies. These have now been filled and the manager has also recruited a team of bank staff who are employed at the home on a relief basis. Thirteen staff have been recruited to the staff team during the same time span. Personnel files were assessed and found to include all required recruitment and legislated clearances, thus: • Enhanced CRB checks, which include POVA checks • A completed application form • Two references • Work permits (where required) • Health checks • Identifying photograph • Other identification such as copies of passports, birth certificates etc • Job descriptions • Contracts/terms and conditions of employment • General Social Care Council code of conduct and the in-house code of conduct for staff (paid and unpaid) • Induction records • Supervision records • Personal development records (appraisals) • PIN numbers (where required) • Individual training records. All initiatives regarding the recruitment of staff, which were within the manager’s remit were noted to be robustly and conscientiously undertaken with much care taken towards ensuring that staff recruited to the team possessed the correct approach and attitude to care, appropriate qualifications as required and clearances that were deemed necessary in line with legislative expectations. It was therefore a pity and a flagrant breach of the Care Homes Regulations 2001 and the Care Standards Act 2000 that the proprietor had appointed a staff member to the administration team without a job description, completed application form, references or required clearances, placing his ‘fitness’ to own a care home in serious doubt. It is thanks to the manager that clearances were retrospectively ensured and the staff member, who is providing excellent administrative support, was ‘shadowed’ until such time those clearances were received. The proprietor is required to ensure that all staff recruitment remains the prerogative of the manager who, as previously stated has a good understanding of the home’s needs and a more practice based knowledge of the legislation that surrounds the process of recruitment, in line with the Care Homes Regulations 2001 and the Care Standards Act 2000. Any future breaches in regulations will result in the matter being referred to the Commission for Social Care Inspection’s legal department so that enforcement action may be considered. Vacant posts are advertised through the local media. All recruitment interviews are conducted by the manager and another nurse. Records of all Parklands Version 1.10 Page 26 interviews conducted are maintained on file. Each staff member is issued with a statement of terms and conditions of employment, which forms an integral part of the staff handbook. The manager reported a reduced level of sickness absence and each absence is underpinned by an informal return to work interview. As per the information outlined above, staff turnover has improved. All staff are inducted to their individual posts. There is a basic orientation induction that familiarises staff with the layout and philosophy of the home and also a TOPPs induction, which takes place during staff’s supervision meetings. Both initiatives are recorded. The home also implements the Mulberry House Ltd induction, which is bound in a booklet, is linked to TOPPs and is a passport to evidence NVQ (outlines which units the candidate is able to cross reference to). The home’s mandatory training consists of: • • • • • • • • Moving and handling Fire awareness First aid Basic food hygiene Health and safety Vulnerable adults Infection control Challenging behaviour. It was advised that dementia awareness is to be included in staff’s mandatory training in due course. Staff have individual training records, which need to be updated but this was clearly in hand. Records centrally collated by the manager indicated that all staff had attended all mandatory training courses to within reasonable timescales and all were well within their recognised time for updates. Staff confirmed that personal development opportunities for them were far more forthcoming and designed to meet core (mandatory) standards, personal development objectives and service users needs. Staff were pleased with the levels of support and encouragement given to them by the manager. The manager has worked extremely hard to ensure that a successful training programme of mandatory training is in place and is to be commended for all her efforts. She is now in the process of planning a programme of needs led training. To this end, the manager has almost completed the annual appraisals, which she is undertaking with the individual staff members. From this, a training and development plan will be formulated for the home in line with service user and staff needs. In addition to ‘in-house’ training the home also avails itself of training offered by Milton Keynes hospital and the local authority social services department. In addition, some training has been undertaken via Network Training, which is linked to NVQ. A number of carers were noted to be undertaking a ‘Principles of Care’ training course via Network Training. Parklands Version 1.10 Page 27 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35, 36 and 38 The manager has developed an effective tool for eliciting service user, staff and stakeholder opinion of the service on an annual basis. However, if the service provision of the home is to continue to improve the proprietor must record the visits he makes to the home in line with Regulation 26 of the Care Home Regulations 2001. The home assumes no responsibility for service users finances other than a small amount of personal allowance, which was found to be effectively managed in line with the assessed finance policy, protecting service users from financial misappropriation. Service users benefit from staff that are supported in their roles, ensuring that their care and support needs are appropriately and effectively met. Health and safety is generally well managed although if the home’s operation is to be fully effective and service users health and safety is to be protected, some work is required to complete generic and fire risk assessments and all initiatives must be recorded. Parklands Version 1.10 Page 28 EVIDENCE: There are several methods in use by the home to ensure that quality standards are maintained. Unfortunately, a requirement that was issued further to the last unannounced inspection of the home that compelled the proprietor to ensure that regular written reports of the Regulation 26 visits made to the home has not been met, although it was reported that the proprietor does visit the home on at least a weekly basis. This continued failure by the proprietor to comply with the Care Homes Regulations 2001 is a pity given that the manager and wider staff team have worked so hard to ensure the home is operated in line with the legislation that falls within their remit. This requirement is therefore repeated and will be further assessed as reports of the Regulation 26 visits to the home are received at the Aylesbury office of the Commission for Social Care Inspection. Any future breaches in regulations will result in the matter being referred to the Commission for Social Care Inspection’s legal department so that enforcement action may be considered. During February 2005, the manager sent a questionnaire eliciting their comments about quality standards to service users, relatives, staff, health and social care professionals. The response rate for the questionnaire was 57 , the results of which the manager published during May 2005. The findings of the questionnaire will be used to prompt service improvement, with staff training and development already hugely improved and service users requirements being more proactively met. The plan for service improvement is due for completion in September 2005. To ensure that quality assurance remains an ‘agenda item’, the following methods are in place to measure quality standards: • • • • • • • • • • Monthly summaries of service users’ plans of care Recorded daily checks of service users bedrooms Six monthly reviews of needs Six weekly reviews for some service users Medication audits every two months Annual stakeholder surveys The manager’s annual quality audit of policies, procedures and the holistic care and support of service users Staff supervision Annual appraisals of staff’s performance A key worker system. Posters announcing this inspection were on display within the home therefore service users had an awareness of the visit and some did take the opportunity to discuss their quality of life at Parklands, commenting that generally, the home provided them with good levels of care and a nice environment. The quality of the food was discussed with no negative Parklands Version 1.10 Page 29 comments forthcoming. As previously stated within the summary of this inspection seventeen comment cards were received in response to this visit. The responsibility for supporting service users to manage their finances and personal business is the prerogative of relatives and/or representatives. The home assumes no responsibility for service users money other than the management of a small amount of personal allowance. There are finance policies in place to guide staff in the appropriate handling of service users finances. Personal allowances are securely held within the home. All deposits and expenditures are noted and periodically audited. Essentially, the home only uses the personal allowances to pay for visits to the hairdresser and therefore this enables the manager to cross reference expenditures to the hairdresser’s records. Toiletries are purchased by relatives and/or representatives and any other expenditure such as visits to the chiropodist are invoiced. The manager is not an appointed agent for any service user. One service user manages their own personal allowance. There is a risk assessment to support this activity and control measures in place that identified the need to have a secure facility to hold any money. Staff receive supervision every two to three months and records of the meetings are maintained on their personnel files. Performance development appraisals are in place, which identify staff’s progress over the past twelve months and their desired and required personal development over the forthcoming twelve months. The manager supervises the middle management of the home and the housekeeping and kitchen managers supervise the staff members they line manage. It is intended that the assistant managers will supervise the staff members they will line manage once the re-structuring of the staff team is completed. The manager is supervised by the proprietor. Staff confirmed the regularity of their supervision meetings as well as general staff meetings and it was evident that they felt valued by the manager and senior staff team and able to have their opinions listened to in a nonjudgemental manner. Service user’s wellbeing and the initiatives of the home are discussed at staff handovers, which take place three times per day, between each shift. General staff meetings have previously taken place on a monthly basis but have recently waned due to the change in the management of the home. Assurances were made that the regularity of general staff meetings will be fully resumed as soon as the re-structuring of the home’s staff team is complete. This aspect of the home’s management will be fully further assessed at the time of the next inspection. Minutes are maintained of general staff meetings. Good progress has been made in relation to health and safety at the home and there are relatively few perceived deficits in relation to this aspect of the home’s management. As previously reported, staff’s individual training records indicated that all staff had attended mandatory training courses to within reasonable timescales and all were well within their recommended times for updates. All accidents and incidents that have occurred at the home are recorded on a pre printed pro forma. A monthly analysis of all accidents and incidents that take place is conducted by the manager and indicated that there had been a Parklands Version 1.10 Page 30 significant reduction in instances. Recording practices in relation to accident reporting was noted to be thorough. The manager is aware of her obligation to report all adverse situations within the home in line with Regulation 37 of the Care Homes Regulations 2001. There is a health and safety policy to guide staff in safe working practices, which is reinforced through health and safety training. Portable electrical appliance tests take place every six months and the initiative results in a report of the activity and any required outcomes. Any possessions that are operable by electricity, which are brought into the home when service users are admitted are tested and a recognised test sticker placed on the appliance to verify its effectiveness. The electrical safety certificate for the hardwiring of the home was dated April 2004 and is valid for approximately a further four years. The gas safety certificates that validates the effectiveness of the homes boilers and central heating system was dated May 2005 and is renewable on an annual basis. The home has recently replaced its boilers and is in the process of replacing the network of pipes that service the central heating system. The manager is addressing the brief lapse in the testing of water temperatures from all hot water outlets, which was a regular occurrence in the home until recently. This aspect of the home’s management will be further fully assessed during the next inspection of the home. External contractors currently undertake the maintenance of the home and it is understood that the process of recruiting a maintenance person to the staff team is in hand. As outlined within the summary, one comment card stated that there was a problem with ant infestation. The home has now appointed a contractor to deal with any issues of infestation as they occur although it is understood that an initial ‘full treatment’ has taken place. This should ensure that instances of ant infestation are not repeated however, from observations and discussions, it would appear that infestation occurred in bedrooms where service users stored sweet drinks and confectionery. Staff and visitors therefore need to have an awareness of the impact to the environment and service users’ wellbeing when bringing confectionery into the home and providing service users with sweet drinks and ensure that all spillages are immediately cleaned and that confectionery is appropriately stored within containers that are inaccessible to ants. The home has two hoists to aid moving and handling. These are subject to a contracted service every six months. Parklands does not have a passenger lift as the parts of the home accessible to service users are of a single storey construction. Clinical waste is discreetly managed within the home and is subject to a contracted collection service via a nationally recognised organisation. There is a policy in place that outlines the use of chemicals within the home (COSHH). Housekeeping and kitchen staff have been trained in the use of chemicals. Data sheets for all chemicals used within the home were in place and included integral risk assessments. Parklands Version 1.10 Page 31 Risk assessments that pertain to the individually assessed vulnerabilities of service users were in place and, as far as can be ascertained were in line with service users’ needs and perceived challenges. Generic risk assessments have been commenced but required completion, which was agreed fro 31 August 2005. Recording on those assessments completed to date, was good with considered control measures in place. Smoke and heat detectors are fitted throughout the home, as appropriate. All fire fighting equipment and the emergency lighting fitted throughout the home is regularly serviced by a recognised contractor and service certificates are maintained. The home’s fire safety inspection is due during August 2005. The requirements issued by the fire safety officer as a result of the August 2004 inspection have been met. The home’s fire risk assessments have recently been reviewed by the manager as part of her annual quality assurance check. The review of fire risk assessments was not clearly evidenced and it is therefore recommended that the manager makes access to that information more user friendly and immediately apparent. Fire awareness within the home is promoted via staff training. Supplementary to training and servicing and inspection reports, fire safety is also promoted through: • • • • Recorded daily means of escape checks Evening security checks The sounding of the alarm bell on a weekly basis from a different call point Regular fire drills. The last recorded fire drill took place on 3 June 2005. With the exception of the record that pertains to the sounding of the fire alarm bell where some gaps presented, all initiatives were well recorded. It is required that concise records are maintained of all initiatives relating to fire safety, including those that pertain to the sounding of the fire alarm bell. An environmental health inspection of the home was conducted on 16 May 2005. Three requirements presented from that inspection. Two had been fully met at the time of this inspection by the Commission for Social Care Inspection. The third requirement was for the proprietor to check the kitchen’s records and scan them to ascertain the appropriateness of the kitchen’s operation and effectiveness of equipment etc. The proprietor was required to validate that the checks of the records had been undertaken via dates and signatures. To date, this requirement has not been complied with. The requirement as outlined within the environmental health officer’s report is concurred with and is therefore also a requirement of this report. Parklands Version 1.10 Page 32 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 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 Standard No 16 17 18 Score 3 x 2 x x 2 x 3 3 x 2 Parklands Version 1.10 Page 33 Yes 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 29 Regulation 17(2) Schedule 4 Requirement Timescale for action 07 July 2005 07 July 2005 2. 33 3. 38 4. 38 5. 38 The proprietor is required to ensure that all staff recruitment remains the prerogative of the manager. 26(1) It is required that the proprietor 26(2)(a-c) records his visits to the home in line with Regulation 26 of the Care Homes regualtions 2001 and that copies of the reports are submitted to the Aylesbury office of the Commission for Social care Inspection. (THIS REQUIREMENT IS REITERATED FURTHER TO THE UNANNOUNCED INSPECTION OF THE HOME, WHICH TOOK PLACE IN SEPTEMBER 2004). 13(4)(a) The generic risk assessments that pertain to safe working practices within the home need to be completed. 12(1)(a) It is required that concise 23(4)(c)(v records are maintained of all ) initiatives relating to fire safety, including those that pertain to the sounding of the fire alarm. 12(1)9a) It is required that, during the regular visits to the home, the proprietor checks the records that are held in the kitchen and acknowledges this initiaitve via Version 1.10 31 August 2005 07 July 2005 07 July 2005 Parklands Page 34 dates and signatures. 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 38 Good Practice Recommendations It is recommended that the manager ensures the reviews of fire risk assessments are clearly evidenced. Parklands Version 1.10 Page 35 Commission for Social Care Inspection Cambridge House, Smeaton Close 8 Bell Business Park, Aylesbury Buckinghamshire 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 Parklands Version 1.10 Page 36 - 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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