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Inspection on 09/08/05 for Parklands Residential Home

Also see our care home review for Parklands Residential Home for more information

This inspection was carried out on 9th August 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home 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, one of the service users summed it up in one word "champion". Staff encourage service users to socialise and get out in the local community as much as possible by accompanying them whenever possible. 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 the 6 care staff have achieved a qualification at NVQ level 2. All staff have been trained in the provision of medication. Fire drills are undertaken once a month.

What has improved since the last inspection?

What the care home could do better:

The assessment procedure in particular with regard to any risks is adequate but could be improved upon and the manager is hoping that the training planned for staff with regard to writing reports and care plans will ensure some improvements in this area. There is still a need to purchase a suitable lockable facility for the storage of medication, as the current cupboard does not meet expected standards.

CARE HOMES FOR OLDER PEOPLE Parklands Residential Home 516 New Hall Lane Preston Lancashire PR1 4TD Lead Inspector Susan Dale Announced 09 August 2005 10:00 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 Residential Home F57 F09 S9847 Parklands V202142 090805 Stage 4.doc Version 1.40 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 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 Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Parklands Residential Home F57 F09 S9847 Parklands V202142 090805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 23/02/05 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 is 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 F57 F09 S9847 Parklands V202142 090805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and various records relating to service users and staff were examined. The inspector was able to speak to staff and service users and the manager of the home. Prior to the inspection, comment cards were provided to service users and relatives/visitors and general practitioners. There were no comment cards received from service users or their relatives, 2 comment cards were returned from general practitioners and their comments have been discussed and taken into consideration as part of the inspection. What the service does well: What has improved since the last inspection? Parklands Residential Home F57 F09 S9847 Parklands V202142 090805 Stage 4.doc Version 1.40 Page 6 There have been improvements to the medication policies and procedures following recommendations made at the last inspection and all staff have been on an Advanced Medication course. All staff are due to attend training on Writing Reports and Care Plans and have attended training on Emergency First Aid (Appointed Persons). The registered manager has also completed the NVQ level 4 in Care and Management qualification. The manager/owner is constantly improving the decorations and décor of the building. A new hoist has been purchased and a new electric bed. 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. Parklands Residential Home F57 F09 S9847 Parklands V202142 090805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Parklands Residential Home F57 F09 S9847 Parklands V202142 090805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 4 & 5 Information is available about the services provided by the home and prospective service users are able to visit the home and try out the services before a final commitment is made. A full assessment is undertaken prior to commencement at the home in order to determine whether the services provided by the home are suitable. EVIDENCE: Documentation belonging to service users was examined and there was evidence that a full comprehensive initial assessment had been undertaken. Generally the home is more suitable for service users who are fairly independent as the home is not purpose built and the manager ensures that any prospective service user will be happy interacting with existing service users as they see themselves as one big family. There are ample training opportunities and staff are encouraged to attend training that ensures they have the necessary skills and experience to deliver Parklands Residential Home F57 F09 S9847 Parklands V202142 090805 Stage 4.doc Version 1.40 Page 9 appropriate care. Specialist services are accessed as necessary according to the individual needs of service users. Prospective service users and their relatives are encouraged to make introductory visits to the home prior to making a decision regarding admission. The registered manager also visits people in their own homes/hospital and unplanned admissions are avoided. Information about trial visits is contained within the Statement of Purpose. Service users confirmed that flexible arrangements are in place to visit the home prior to a decision to reside at the home on a permanent basis. Parklands Residential Home F57 F09 S9847 Parklands V202142 090805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 10 An appropriate care plan is devised that ensures physical, health and emotional needs of service users are met. 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. 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. A Pharmacist Inspector made several recommendations at the last inspection and the majority of these has been implemented. A medication policy is in Parklands Residential Home F57 F09 S9847 Parklands V202142 090805 Stage 4.doc Version 1.40 Page 11 place and the registered manager ensures that the procedures are followed correctly. As recommended at the last inspection, a new storage cupboard for medication has been installed but the manager is not happy with the design and wants it replaced, improved storage facilities should be in place by the next inspection. Service users, where appropriate are able to take responsibility for administering their own medication; risk assessments have been carried out regarding the self-administration of medication and are included with the care plan. The registered manager discussed issues connected with a service user who is able to self medicate and requires oxygen; the pharmacist and social worker have also been contacted to ensure that all possible areas of risk associated with self medication and the storage of the medication are covered. Service users confirmed that staff are very caring, respect their privacy and treat them with dignity. General Practitioners returned comment cards that provided evidence that they were able to see service users in private and staff 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 F57 F09 S9847 Parklands V202142 090805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 & 14 The home provides activities that meet the expectations and capabilities of the service users and visitors to the home are made to feel welcome at all times. EVIDENCE: Routines at Parklands are flexible and responsive to the needs of service users. The interests and preferred activities of service users are recorded on the care plan and service users are encouraged and supported to take part in a variety of leisure activities both inside and outside the home. Service users are made aware of planned activities through the provision of a notice board with this information being verbally reinforced. Service users spoken to confirmed that they are encouraged to take part in any activities including Bingo that takes place every afternoon. Service users confirmed that they are supported to maintain contact with family, friends and the wider community. Service users are encouraged and escorted by staff to attend bingo sessions within the local community. The manager is aware of appropriate advocacy services and how these can be accessed on behalf of service users. Parklands Residential Home F57 F09 S9847 Parklands V202142 090805 Stage 4.doc Version 1.40 Page 13 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 & 18 Policies and procedures are in place to ensure that service users are protected from abuse and any complaints/concerns are recognised and acted upon. 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. Through discussion with the manager and staff, and viewing documentation it was evident that the safety and protection of service users is given a high priority. 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. Parklands Residential Home F57 F09 S9847 Parklands V202142 090805 Stage 4.doc Version 1.40 Page 14 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) There were no standards assessed at this inspection. EVIDENCE: Parklands Residential Home F57 F09 S9847 Parklands V202142 090805 Stage 4.doc Version 1.40 Page 15 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, & 30 Service users are cared for by appropriate staff who have been provided with training that enables them to meet their needs. EVIDENCE: The number of staff on duty is in accordance with previous local authority guidance. There are no staff under the age of eighteen years. Documentation belonging to the recruitment of new staff were examined. There is an appropriate recruitment policy and procedure that includes a job application form requiring a detailed history of previous employment and two references. The procedure has been improved following recommendations made at previous inspections. New staff are checked via the Criminal Records Bureau and the Protection of Vulnerable Adults Register (POVA). The manager demonstrates a commitment to the training and development of their staff. Staff spoken to confirmed that they are encouraged to attend training and had found it enjoyable; they had just attended First Aid (Appointed Person) Training. Other training has been Advanced Medication and staff are due to attend training on Writing Reports and Infection Control. There are 6 care staff and 4 of them have achieved a qualification at NVQ level 2. The staff induction includes the key elements as specified by the National Training Organisation for Personal Social Services (NTO). Parklands Residential Home F57 F09 S9847 Parklands V202142 090805 Stage 4.doc Version 1.40 Page 16 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) 31, 32 & 38 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. EVIDENCE: The registered manager has recently 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. Secure facilities are provided for the safe keeping of money and valuables on behalf of service users. Parklands Residential Home F57 F09 S9847 Parklands V202142 090805 Stage 4.doc Version 1.40 Page 17 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 F57 F09 S9847 Parklands V202142 090805 Stage 4.doc Version 1.40 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x x x x 3 Parklands Residential Home F57 F09 S9847 Parklands V202142 090805 Stage 4.doc Version 1.40 Page 19 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 9 Regulation 13(2) Requirement The proprietor to ensure all medicines are stored securely with reference to the wooden storage cupboard. Timescale for action 1.10.05 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 9 Good Practice Recommendations Appropriate storage should be provided for the handling of controlled drugs. Parklands Residential Home F57 F09 S9847 Parklands V202142 090805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Unit 1, Tustin Court Portway Preston PR2 2YQ 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 Residential Home F57 F09 S9847 Parklands V202142 090805 Stage 4.doc Version 1.40 Page 21 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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