CARE HOMES FOR OLDER PEOPLE
Parkside 65 Main Road Gidea Park Romford Essex RM2 5EH Lead Inspector
Rhona Crosse Unannounced Inspection 11 July 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. Parkside G55_S0000027871_Parkside_V236752_110705_Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Parkside Address 65 Main Road, Gidea Park, Romford, Essex RM2 5EH 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) 01708 743110 Romford Baptist Church Housing Assn Ltd Miss Christine Brown CRH Care Home 32 Category(ies) of OP Old Age (32) registration, with number of places Parkside G55_S0000027871_Parkside_V236752_110705_Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 26 January 2005 Brief Description of the Service: Parkside is a large house in Main Raod Romford that has over time been converted and extended to provide accommodation for 32 older people. The home is a care home and provides 24 hour care. The home does not provide any nursing care. The home has a mature garden and there is ample parking space for visitors. The home is in easy walking distance of local amenities and transport links. Parkside G55_S0000027871_Parkside_V236752_110705_Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection so the home did not know the inspector was coming. The inspector arrived at the home at 10am. The manager was attending a training course and was not at the home. The deputy manager was in charge of the home and assisted with the inspection. A morning service was taking place when the inspector arrived. The home was clean and tidy throughout. Refurbishment work to a W.C. was taking place. The redecoration of the lounges and hallway downstairs that were being carried out at the time of the last inspection have now been completed. New curtains are to be provided for the smaller lounge. The garden has been redesigned in one area with a patio and water feature. This has been part of a project where local school children assisted with the creation of this new seating area. Staffing levels were appropriate for the needs of the service user’s at the time of the inspection. Staff were observed to go about their duties quietly and professionally. What the service does well: What has improved since the last inspection?
Parkside G55_S0000027871_Parkside_V236752_110705_Stage 4.doc Version 1.40 Page 6 Care plans inspected are now being updated on a regular basis. Staff are now receiving formal written supervision on a regular basis. The decoration of the hallway has now been completed and the decoration ad refurbishment of the two lounges is almost complete. New curtains are ordered for the smaller lounge. 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. Parkside G55_S0000027871_Parkside_V236752_110705_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 Parkside G55_S0000027871_Parkside_V236752_110705_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) 1, 3 & 5. The home does not provide the service standard 6 applies to. These standards are well managed. EVIDENCE: The home has a Statement of Purpose and a Service Users Guide these documents tell the prospective service user about the service the home provides. The home carries out a pre admission assessment for anyone coming into the home to ensure that the home can meet the needs of that person. As random selection of assessments were inspected. Information gained was thorough and recorded fully the needs of service users. Prospective service user’s are encouraged to visit the home prior to moving in and may stay for lunch if this is their wish, to get to know what it is like living in the home. Once it is agreed that the home can meet the needs of the service user an admission will take place. After 4-6 weeks a review will be held to discuss whether the home meets the expectation of the service user and if
Parkside G55_S0000027871_Parkside_V236752_110705_Stage 4.doc Version 1.40 Page 9 the home can meet the needs of the of the service users. At this point a decision is made as to whether the placement will become permanent. Parkside G55_S0000027871_Parkside_V236752_110705_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, 9, 10 and 11. These standards, 7,8,10 and 11 are well managed. Standard 9, medication practice, needs to be monitored more closely. EVIDENCE: A random selection of service users files were inspected. It was observed that care plans are being updated and that risk assessments and manual handling risk assessments are being reviewed and were up to date. Good practice was seen where a new risk assessment had to be put into place on return from hospital for one service user, with areas of infection control documented and put into practice, with information provided for staff. Health care needs are well documented with information recorded when other health care professionals visit. In discussion with service user’s they confirmed that they were well care for and that contact was made various health professionals. One service user said ‘they look after us well they call the GP when we are not well, nothing is left to chance’. Another service user said ‘staff treat us with respect they are very
Parkside G55_S0000027871_Parkside_V236752_110705_Stage 4.doc Version 1.40 Page 11 caring, nothing is too much trouble, matron will sort anything out if you speak to her.’ Service users confirmed that staff always knock on doors before entering and this was observed by the inspector. A service user said ‘staff always knock on my door before they come in’. ‘staff respect my privacy’, I can come to my room when I like, I spend most of my time in my room , but we all go down to eat together’. An audit of medication was carried out. It was observed that no amount of Amoxycillin capsules dispensed had been recorded or the date the medication was received. All medication received into the home must show the date it is received and the amount of medication dispensed from the pharmacy. There were gaps on the medication administration sheet (4 times) where staff had not signed that they had administered a particular medication. However when the monitored dosage system was checked this medication had been given. The manager must monitor this more closely. Good practice was seen where service user’s are responsible for their own medication administration. The home keeps a record of all checks made to ensure the medication has been taken as prescribed. Parkside G55_S0000027871_Parkside_V236752_110705_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. Standards 14 and 15 will be insepcted at further inspections. These standards are well managed. EVIDENCE: The home is run by Romford Baptist Church and therefore some activities relate to religious services. Service user’s coming to live at the home are aware of this. The Church visit once a month and hold a service in the home. There is the Tuesday fellowship meeting and also an evening meeting that takes place on a Thursday. There is an activities co-ordinator who visits the home on Wednesdays once a fortnight and assists with other activities. These range from board games, quizzes arts and crafts. Debates and quizzes with the administrator about different topics also take place. Trips out to the shops take place and outings such as afternoon tea at High Beech are organised. Links with the local community are encouraged and a local school supports the home with the children coming to play musical instruments to the service user’s. A recent project was to create a patio area accessible for wheelchairs
Parkside G55_S0000027871_Parkside_V236752_110705_Stage 4.doc Version 1.40 Page 13 with a water feature. The children assisted with this. This was completed very recently. There are no set visiting times relatives can come and go as they please. Two relatives were visiting at the time of the inspection. Parkside G55_S0000027871_Parkside_V236752_110705_Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 will be inspected at further inspections. EVIDENCE: Parkside G55_S0000027871_Parkside_V236752_110705_Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25, 26 These standards are well managed with continuous refurbishment taking place some planned for later in the year. EVIDENCE: A random selection of service user’s bedrooms were inspected. All were found to be clean and well decorated. A new en-suite had been created in bedrooms 22 and 23, the work was carried out to a high standard. Refurbishment work was taking place in one W.C. at the time of inspection. Other work planned is a new carpet and vanity unit in bedroom 8. Four new carpets are being provided for bedrooms. Bedrooms were very individual and full of personal possessions. Service user’s are able to bring small pieces of furniture with them for their rooms. Bathrooms were clean and free from odours. There is sluice sink in the upstairs bathroom that must be relocated. This was a requirement at the last inspection. In discussion at this inspection due to the work entailed this will not
Parkside G55_S0000027871_Parkside_V236752_110705_Stage 4.doc Version 1.40 Page 16 be able to be completed until October 2005 therefore a new timescale has been set. There are aids and adaptations in bathrooms to assist service users in and out of the bath. Other specialist equipment for lifting and pressure relief are provided. Parkside G55_S0000027871_Parkside_V236752_110705_Stage 4.doc Version 1.40 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 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) 30. Standards 27, and 29 will be inspected at further inspections. This standard is well managed. EVIDENCE: Staff training is provided and each staff member has a training profile identifying the training undertaken and the training that is to be offered. On the day of the inspection the manager had gone to first aid training (the 3 year certificated course). Two staff hold NVQ level 3 training and two have started NVQ level 2 training this year. One staff member has completed BETEC introduction to care. A fire drill and evacuation took place on 10/5/05 for new staff. Food hygiene training took place on 24/5/05, adult protection training took place on 28/4/05. Health and safety training took place on the 24/6/05. Parkside G55_S0000027871_Parkside_V236752_110705_Stage 4.doc Version 1.40 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 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) 36 and 38. Standards 33 and 35 will be inspected at further inspections. These standards are well managed. EVIDENCE: Staff supervision is taking place. Dates of completed staff supervision were seen by the inspector. The health and safety aspect of the home was discussed in relation to one service user I.C. who had complained about the temperature of the hot water being too cold many times. The inspector informed the home that they should first seek advice from the Health and Safety Executive about guidance for the maximum temperature of hot water as the HSE HS(G) 104 book states “ with water at a temperature
Parkside G55_S0000027871_Parkside_V236752_110705_Stage 4.doc Version 1.40 Page 19 above 50 degrees Celsius there is a risk of scalding” Once guidance has been gained this must be discussed with the service user, relatives or any advocate and a thorough risk assessment carried out. This risk assessment must be updated and recorded to ensure the service user continues to understand the risks and that relatives or any advocate are kept involved at all stages. The home has to ensure the well being of service user’s at all times. Health and safety checks carried out were recorded as :the annual Gas safety check was dated 3/12/04. The stair lift was serviced in April 2005, the passenger lift was serviced on 13/1/05. The hoists and bath hoists were serviced on 15/6/05. The fire extinguishers received their annual check in October 2004. Fire drills are taking place and these were recorded as 7/10/04 and 10/5/05, the weekly fire call points are being tested and a record is kept of these. The emergency lighting was checked on the 5/4/05. The fire officer visited in January 2004 there were no requirements made from this visit. The routine pest control visit took place on the 16/6/05 with no problems noted. The Environmental Health Officer last visited in September 2004 there are no outstanding requirements. The Pharmacist visited the home on the 24/1/05 to check the storage administration and recording of medicines held in the home. The Legionella test was carried out on the water system on the 17/5/05. It was observed that fridge and freezer temperatures for May 2005 were not always being recorded each day for week beginning 2/5/05, 23/5/05 and for week beginning 30/5/05. The home must ensure that a daily record is kept. Parkside G55_S0000027871_Parkside_V236752_110705_Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x
COMPLAINTS AND PROTECTION 3 3 2 3 3 3 3 3 STAFFING Standard No Score 27 x 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x 3 x 2 Parkside G55_S0000027871_Parkside_V236752_110705_Stage 4.doc Version 1.40 Page 21 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. 2. 3. Standard OP9 OP21 OP38 Regulation 13(2) 13(3) 13(4)(b)& (c) Requirement The signing of medication administered must be monitored more closely. Move the sluice sink out of the bathroom and resite in an appropriate area. Guidance from the Health & Safety Executive about the maximum safe water temperature must be gained in writing. A risk assessment must be completed prior to any increase in the water temperature of I.C.s hot water and this must be reviewed at regular intervals to ensure ongoing safety. The home must ensure the safety of service users at all times. Fridge and freezer temperatures must be taken daily and recorded. Timescale for action 11/7/05 and ongoing. 31/10/05 Prior to any increase in water temperature. Prior to any increase in temperature. 4. OP38 14(2)(a)( b) 5. OP38 16(2)(k) 11/7/05 and ongoing action. Parkside G55_S0000027871_Parkside_V236752_110705_Stage 4.doc Version 1.40 Page 22 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 OP38 Good Practice Recommendations Discussions with the service user, relatives any advocate or social worker should take place prior to any increase in the water temperature in the bedroom of I.C. Parkside G55_S0000027871_Parkside_V236752_110705_Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Ferguson House 113 Cranbrook Road Ilford Essex IG1 4PU 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 Parkside G55_S0000027871_Parkside_V236752_110705_Stage 4.doc Version 1.40 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
