CARE HOMES FOR OLDER PEOPLE
Parklands Residential Home 516 New Hall Lane Preston Lancashire PR1 4TD Lead Inspector
Ms Susan Dale Key Unannounced Inspection 3rd April 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Parklands Residential Home DS0000009847.V330686.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Parklands Residential Home DS0000009847.V330686.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Parklands Residential Home Address 516 New Hall Lane Preston Lancashire PR1 4TD 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) 01772 795675 Mr Chattargoon Seetal Mrs Narainee Seetal vacant post Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (13), Physical disability (1) of places Parklands Residential Home DS0000009847.V330686.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The service is registered to accommodate a maximum of 14 service users to include 13 service users in the category OP (older persons 65 and over) and 1 service user in the category PD (physical disability). 14th February 2006 Date of last inspection Brief Description of the Service: Parklands Residential Home is a two storey detached building located on one of the main thoroughfares of Preston. The home is close to local amenities and has a garden area to one side and parking to the rear. Parklands are registered to provide personal care to fourteen older persons of both sexes. There is a clear commitment to provide a high quality of individualised care and promote the independence of service users, within a homely atmosphere. Social activities both within and outside the home are arranged in consultation with service users and visitors are made welcome. Parklands Residential Home DS0000009847.V330686.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The visit was unannounced and focused on key standards. The inspector was able to speak to service users and staff and examine various records. Comment cards were provided to service users, relatives/friends and health professionals prior to the inspection. 5 comment cards were returned from service users/relatives. All the responses were very positive and the results were taken into account as part of the inspection. A tour of the premises took place. What the service does well:
The home is small and homely and the staff and manager operate as a team with good communication. Service users expressed their satisfaction with the care and services provided and the friendliness of the staff. Staff encourage service users to socialise and go out in the local community by accompanying them whenever possible. The home is small and very homely, the staff and manager operate as a team with good communication. Service users expressed their satisfaction with the care and services provided and the friendliness of the staff. A new service user expressed her satisfaction with the welcome she had received at Parklands and the trouble that was taken to ensure that her room was to her satisfaction with her choice of decoration and curtains. Staff encourage service users to socialise and get out in the local community as much as possible by accompanying them whenever possible. The healthcare needs of service users are very well provided for, with the manager ensuring that physiotherapy is provided once a week and personally ensuring that exercises are maintained, and thereby increased the mobility and confidence of certain service users. Comments included: “At Parklands she received physiotherapy every day and her confidence has soared.” The manager always personally accompanies service users when they have hospital or specialist health appointments and provides transport. Effort is taken to encourage the service users to try different foods and visitors to the home confirmed that they are made most welcome and have been offered a meal as well as a drink. The following comment was from a relative: Parklands Residential Home DS0000009847.V330686.R01.S.doc Version 5.2 Page 6 “There is always a choice of meals and residents are regularly asked if there is anything in particular that they would like. ‘Tasting days’ take place so that they can try something different.” Training is given high priority and the registered manager is very responsive to changing needs and seeks out training that will be useful to the staff in their care of service users. 4 out of 7 care staff have achieved a qualification at NVQ level 2. Training is given high priority and the registered manager is very responsive to changing needs and seeks out training that will be useful to the staff in their care of service users. 4 out of 7 care staff have achieved a qualification at NVQ level 2. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Parklands Residential Home DS0000009847.V330686.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Parklands Residential Home DS0000009847.V330686.R01.S.doc Version 5.2 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. A full assessment is undertaken prior to commencement at the home in order to determine whether the services provided by the home are suitable. The home does not provide intermediate care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Documentation belonging to a new service user was examined and there was evidence that a full comprehensive initial assessment had been undertaken. The service user and a friend who was visiting confirmed that that everything possible had been done to ensure that she was comfortable and happy when she first moved into the home. The service user was able choose the décor and fabric of the curtains and duvet despite the fact that the original curtains were perfectly acceptable. The registered manager explained that she wants all the service users to feel very much at home and this was confirmed by the service user. A relative made the following comment:
Parklands Residential Home DS0000009847.V330686.R01.S.doc Version 5.2 Page 9 “She was heartbroken when she had to leave her home and spent a lot of time crying. Now she is happier than I have ever seen her. Every aspect of Parklands is faultless. The staff are caring and supportive.” One service user does not speak English and the family act as interpreter. The manager has ensured that she is comfortable by learning some key words of Gujerati and as confirmed by the family she has settled well and is far happier at Parklands than she was at a previous residential home. Parklands Residential Home DS0000009847.V330686.R01.S.doc Version 5.2 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is excellent. Appropriate policies and procedures are in place to ensure the Health, Safety and Welfare of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A care plan has been devised for each service user that looks at Goals and how these can be met. The care plans had been reviewed once a month in order to be responsive to the changing needs of service users. A signature is obtained from the service user on the care plan and at each review. There was evidence on the documentation that the home promotes and maintains service users’ health and provides access to a range of health care services as appropriate to the needs of each individual. Self care is supported and encouraged with care plans and diary sheets reflecting detailed attention being given to the physical and psychological health needs of service users. All service users are registered with a GP of their choice and there was documentary evidence of appropriate nutritional screening and specialist health service involvement. Service users, where appropriate are able to take responsibility for administering their own medication; risk assessments have
Parklands Residential Home DS0000009847.V330686.R01.S.doc Version 5.2 Page 11 been carried out regarding the self-administration of medication and are included with the care plan. Three staff and the manager have completed certificated training in ‘Safe Handling of Medication’. The manager has previously worked in Physiotherapy and under the direction of a qualified physiotherapist, who visits the home every Friday, has ensured that service users carry out exercises that have significantly improved their flexibility. One service user made the comment that it was only through the manager’s encouragement that she had regained some mobility following an operation. A relative made the following comment: “At Parklands she received physiotherapy every day and her confidence has soared.” The manager always personally accompanies service users when they have hospital or specialist health appointments and takes them in her car at no expense to the service user. Service users confirmed that staff are very caring, respect their privacy and treat them with dignity they demonstrated a clear understanding of the care needs of service users. Personal care is provided in the privacy of individual bedrooms or bathrooms and screening is available in the 2 double bedrooms. Service users have access to a pay phone for making personal calls. Parklands Residential Home DS0000009847.V330686.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. The home provides activities that meet the expectations and capabilities of the service users and there is a varied menu that provides that provides a choice of nourishing meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A great deal of effort is made to ensure that service users are happy and feel as if they are within a family atmosphere. The care plan details the wishes and expectations of each service user and their choices with regard to food, social interaction, hobbies and interests and religion. Activities include Bingo and gentle exercises take place every day, a ball and a basket have been purchased. Outings take place in the home’s mini bus to Southport and Blackpool and the manager takes service users within her own car on trips out. The manager has asked a Yoga Teacher to come and visit the home in order to assess and find out whether Yoga would be of benefit to service users who wish to participate. Staff accompanies one service user each week to a local club and a member of the club brings her back. Music and dancing are also provided and photographs about times past.
Parklands Residential Home DS0000009847.V330686.R01.S.doc Version 5.2 Page 13 Because some service users were no longer able to visit their church, the manager purchased a religious cross and had it blessed by a local priest. A small corner of the conservatory has been set up with the cross and electric candles as a focal point. Some of the service usershave very little money and the manager ensures that essential clothing is provided. A service user was being fitted with slippers provided by the home on the day of the site visit. Meals are served in an attractive and well-appointed dining room overlooking the garden area. Discussion with individual service users indicated that meals are varied and appealing, and the menus show that a nutritious and balanced diet is provided. Service users confirmed that mealtimes are flexible and unhurried and are offered individual choices aside from the main menu. In order to encourage new ideas for meals ‘taster days’ have commenced where the service user can taste something new. A relative made the following comment. “There is always a choice of meals and residents are regularly asked if there is anything in particular that they would like. ‘Tasting days’ take place so that they can try something different.” The home employs the services of a full time cook and one of the carers covers for her at other times. Parklands Residential Home DS0000009847.V330686.R01.S.doc Version 5.2 Page 14 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. Policies and procedures are in place to ensure that service users are protected from abuse and any complaints/concerns are recognised and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an appropriate complaints policy in place with a summary of this policy available for each service user within their bedrooms. Any concerns are addressed promptly with the focus on resolving any differences as quickly as possible. The complaints policy includes appropriate timescales for responding and no complaints have been received by the home or any made to the Commission for Social Care Inspection. The home has policies on abuse and whistle blowing in place, available for all staff to access. The manager has a copy of the “No Secrets in Lancashire” document and is familiar with it’s content; the document has been incorporated into the home’s abuse policy. All staff have received training in Adult Abuse and Whistle Blowing. Parklands Residential Home DS0000009847.V330686.R01.S.doc Version 5.2 Page 15 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. The home provides a comfortable safe environment that meets the needs of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well maintained and meets service users’ needs in a comfortable and homely way. A programme of maintenance and renewal is ongoing. The parking and garden areas are kept safe and tidy with service users having full access to these external areas. The internal environment is attractive and domestic in character. Since the last site visit there have been improvements in all areas. The office area located in the downstairs hall now has a door to ensure privacy. All the hall and landing walls have been painted and floorboards on the landing adjusted to stop them squeaking. A number of windows have been replaced and the work is ongoing. In the lounge there are new leather chairs and four electric beds have been purchased. A ramp is to be installed to ease access
Parklands Residential Home DS0000009847.V330686.R01.S.doc Version 5.2 Page 16 into the conservatory. Two new showers have been installed in the communal bathrooms. Increased security measures have been put in place with an alarm fitted following a burglary. The home is now a non-smoking home and the one service user who smokes a pipe is assisted to go outside and provided with very warm clothing and a hat whilst they are outside. A copy of the Fire Safety Officers Report was seen dated the 28/02/07 that confirmed the ‘risk assessment’ measures taken by the home were up to standard. The home was very clean and tidy in all areas. Parklands Residential Home DS0000009847.V330686.R01.S.doc Version 5.2 Page 17 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is excellent. Staff have been recruited appropriately and provided with training that gives them the skills to look after vulnerable service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are currently 14 service users with the majority fairly independent; excluding the manager there are 7 care staff and 1 additional care staff is in the process of being recruited. There is an appropriate recruitment policy and procedure that includes a job application form requiring a detailed history of previous employment and two references. New staff are checked via the Criminal Records Bureau and the Protection of Vulnerable Adults Register (POVA). Staff training is seen as a priority and staff confirmed that they have recently attended 5 training courses that are provided within the home. The training included, Fire Safety, Moving and Handling, Diabetic Care, Care of Stroke and Health and Safety. Out of the 7 staff, 4 have obtained a National Vocational Qualification (NVQ) in Care. Continuity of staff has been maintained with staff employed confirming that they were provided with an induction when they commenced at the home. Parklands Residential Home DS0000009847.V330686.R01.S.doc Version 5.2 Page 18 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. The service users benefit from the competency and leadership of the manager and are given every opportunity to participate in the running of the home. The health, safety and welfare of the service users and staff are protected by the policies and procedures operating in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has obtained a qualification at NVQ level 4 in Management and Care; has already obtained the NVQ D32/33 award and the N.E.B.S. Introductory Management course. Staff confirmed that they are well supported by the manager and encouraged to participate in the running of the home. There are clear lines of accountability within the home and a team approach is taken at all times.
Parklands Residential Home DS0000009847.V330686.R01.S.doc Version 5.2 Page 19 Staff meetings are held once a month and one to one supervisory meetings every 8 weeks. The manager’s husband who is also the Responsible Individual for the home sometimes takes staff meetings to ensure that staff are happy with the way the home is managed. Staff spoken with confirmed that the manager is very approachable and that she encourages them in every way to assist in the running of the home. The home has already been awarded ‘Investors in People’ status and is employing the services of an outside agency to assess all aspects of the home in order to improve the service provided as much as possible. The home has also met the standards required by Social Services and has been classified as Band 1 which, is the highest quality band, as a ‘Preferred Provider’. Documentation and discussions with the manager and staff provided evidence that the health welfare and safety of both staff and service users is important. Staff have received training in safe working practices such as, moving and handling, first aid, food hygiene and fire safety. Risk assessments are undertaken on each service user with regard to their needs and abilities. Relevant policies are in place including an infection control policy. A health and safety checklist is maintained of all systems relating to electrical equipment, fire safety, the lift etc. Parklands Residential Home DS0000009847.V330686.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Parklands Residential Home DS0000009847.V330686.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Parklands Residential Home DS0000009847.V330686.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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