Inspection on 04/09/07 for Parkside

This inspection was carried out on 4th September 2007.

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

Parkside 10/08/06

Parkside 12/01/06

Parkside 11/07/05

Parkside 26/01/05

Parkside 20/05/04

Parkside 13/01/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Parkside 65 Main Road Gidea Park Romford Essex RM2 5EH Lead Inspector Julie Legg Unannounced Inspection 09:30a 4 – 13 September 2007 th th 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 Parkside DS0000027871.V349601.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. Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parkside Address 65 Main Road Gidea Park Romford Essex RM2 5EH 01708 743110 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) parksidehome@btinternet.com Romford Baptist Church Housing Association Limited Mrs Gillian Dawn Littleboy Care Home 32 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (32) of places Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. As agreed on 08/06/2006, one named Service user (Female), with Dementia, can be accommodated within the home. 15th January 2007 Date of last inspection Brief Description of the Service: Parkside is a registered care home for 32 people aged 65 and over. Parkside is operated by the Romford Baptist Church Housing Association Ltd., a registered charity. The home is run on a Christian basis, and most of the staff are Christians. However, the registered providers accept people from all beliefs and backgrounds. The home is situated in a residential area of Romford. It is on several bus routes and approximately a fifteen minute walk from a main line station. The home is a large two storey detached house with extensions, the house is set back from the main road and surrounded by well-maintained gardens. The accommodation is over two floors two of the bedrooms are double rooms and the remaining rooms are single with either en-suites or wash hand basin facilities. There are ample toilet and bathing facilities on both floors, which are served by a passenger lift. There are three communal lounges including the conservatory and a spacious dining room. There is also a pleasant and wellmaintained garden at the back of the home. The Statement of Purpose and the Service User Guide are available to every prospective resident and every resident has a copy of the Service User Guide. A copy of the Statement of Purpose and the most recent inspection report is available from the office. The current fees for the home are between £421-£465 a week, this information was provided by Gillian Littleboy (registered manager) on 4th September 2007 Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over a day, the manager was present during the inspection and was available for feedback at the end of the inspection. The visit included discussions with the manager, the administrator and the maintenance manager. The inspector spoke to care staff about the care residents receive and observed them carrying out their duties. The inspector also spoke to a number of residents who were able to give their views on the service and their experience of living at Parkside. Relatives, health and social care professionals were also asked for their comments. A tour of the home was undertaken; the standard of cleanliness was extremely high and no offensive odours were present throughout the home. A random sample of residents’ files were case tracked, together with the examination of staff and other records. These included medication administration, staff rotas, training schedules, maintenance records and staff recruitment procedures and files. Additional information relevant to this inspection has been gained from the Annual Quality Assurance Assessment, monthly Regulation 26 reports and Regulation 37 notifications. The inspector had a discussion with the manager and people living in the home about how they wished to be referred during the inspection and in the report. They expressed a wish to be referred to as residents. This is reflected accordingly throughout this report. The inspector would like to thank the residents, and staff for their input during the inspection. What the service does well: The home has a very welcoming atmosphere and the standard of cleanliness was very high. Residents, relatives and staff all spoke about Parkside as being a very nice place to live and work. Residents and relatives talked about Parkside being homely and like a family (there are currently a married couple, a brother and sister and two sisters living at Parkside) and that staff are kind and approachable. Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 6 Residents were very complimentary and stated, “I have lived here for ten years and I wouldn’t want to live anywhere else”, another stated, “Everyone is really kind, I am quite content”, “We are really looked after, nothing is too much trouble”. Relatives were also complimentary, one stated, “I am very happy with the care, the staff are kind and I have confidence in Gillian (manager)”, another stated, “They all do an excellent job”. Staff retention is excellent with a number of staff having worked at the home for over fifteen years and staffing levels are more than adequate. All of the care staff that were spoken to were very aware of the residents and their needs. Two members of staff stated, “I feel privileged to work here”, another stated, “I really enjoy coming to work, we work as a team”. Comments from both health and social care professionals were very positive. One health care professional stated, “I am booking myself a bed, the care is excellent”. A social care professional stated, “The home is providing a very good service”. What has improved since the last inspection? The manager and staff have made some significent improvements since the last inspection. All residents are now assessed prior to admission to the home. All residents now have care plans in place, which are kept under review. All residents’ health care needs are now being met and the manager and some of the staff have attended a distance- learning course with Hackney College in ‘The safer handling of medication’; this course is certified by the National Certificate of Further Education. All staff have attended training in ‘safeguarding adults’, fire training and the Mental Capacity Act and staffing levels have been increased. The home has undergone some redecoration and refurbishment since the last inspection; the kitchen has been refurbished with stainless steel fixtures and fittings and the sluice room has been upgraded. The front and side of the house has undergone major repairs and the front garden has been renovated. The dining room has been refurbished with new carpets and light fittings and new blinds have been installed in the conservatory. Some of the bedrooms have new furniture and vanity units and an information file on the home has been placed in each bedroom. The extending and total refurbishment of the annex is on track and is due to be finished by November; this will give the home an extra five single ensuite bedrooms. Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 7 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. Parkside DS0000027871.V349601.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Parkside DS0000027871.V349601.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3, and 5 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. Prospective residents and their relatives have detailed information on the home, which assists them to make an informed choice about moving into the home. A pre-admission assessment is undertaken of all prospective residents, this will ensure that their identified needs can be appropriately met by the home. Prospective residents and their relatives are able to visit the home prior to their admission. EVIDENCE: The home has a Statement of Purpose and a Service User Guide; both of these documents have been reviewed this year. The Statement of Purpose has been updated to reflect the increase in the staff NVQ ratio and sets out the Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 10 objectives and the philosophy of the service and what the home can and cannot provide. The Service User Guide has now been produced in large print, it is informative and written in plain English and is provided to all prospective residents along with the home’s brochure. The files of three residents were examined. The manager has undertaken an assessment, which covers: personal care, mobility, transfers, communication, medical history covering physical and mental health, and dietary and religious needs. Two of the residents have an assessment of need from their local authority and further information has been gathered from families, GPs and hospitals. From this information a care plan is developed (see standard 7). Residents and relatives are able to visit the home prior to a resident moving in. In some cases the family have visited, one relative stated, “I looked at three other homes but I just knew that my Mum would be happy here and I haven’t been disappointed”. A resident stated, “ I visited a couple of times before I decided to move and I would recommend the home to anybody”. The home does not provide Intermediate care. Parkside DS0000027871.V349601.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The health, social and personal care needs of the residents are set out in individual care plans. These plans provide the staff with information to ensure that residents’ needs are appropriately met. There are detailed risk assessments, which have been evaluated and reviewed and clear medication policies and procedures for staff to follow and most of the medication records are being completed correctly. Therefore residents’ safety and welfare are protected. Residents are treated with respect and dignity and their arrangements for their personal care ensures that their privacy is upheld. Residents and relatives can be assured at the time of the resident’s death their wishes will be respected. Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 12 EVIDENCE: Every resident has their own care plan; three of these care plans were case tracked and related documentation inspected. Care plans include details of each resident’s health, personal care, social, cultural and religious needs. The care plans are detailed and provide staff with sufficient information to ensure that residents’ care needs are being fully met. Care plans are detailed, such as, ‘Y prefers a shower to a bath’ ‘X only requires assistance with washing her back’ and ‘Z prefers to have their nighttime drink in the lounge’. Staff spoken to know the needs of the residents whose care plans were case tracked and they were able to describe the details of the care plans. Care plans are being regularly evaluated and updated and there was evidence that residents have been involved with their care plan reviews, as on the day of the inspection the inspector was able to observe a member of staff sitting with a resident and going over his revised care plan; this was to ensure he fully understood the changes that had been agreed. Seven of the residents are funded by the local authority (London Borough of Havering) and their placements were reviewed in May 2007. All of the placements continue to meet the needs of these residents. A social care professional stated, “ All of the residents and relatives were very happy with Parkside, one small issue was raised and this was dealt with by the manager”. The remaining residents are self-financing and the manager has commenced yearly placement reviews with these residents. Daily records indicated that care plans are being followed. Risk assessments are routinely undertaken on admission for all residents around nutrition, bathing, self-medication, dressing, falls and pressure sore prevention. There was evidence that these risk assessments have been reviewed on a regular basis. Residents’ health needs are clearly identified as part of their care plan and how these needs should be met. Records indicate that health care professionals, such as, dentist, optician, chiropodist, continence nurse, community nurse and GP see residents either at Parkside or at their surgeries. The practice nurse from the local Health Centre visits every Friday, when she discusses with the manager or the residents any health issues they might have. One resident stated, “I have seen the optician and got these new glasses”, a relative stated, “They act very quickly in calling the GP if she isn’t well”, another relative stated, “Her physical and emotional wellbeing have improved since she has lived here”. Residents are weighed on a monthly basis and any significent weight losses or gains are discussed with the nurse practitioner. A health care professional stated “The care here is excellent, all of the residents’ health needs are dealt with effectively and new issues are bought to my attention straight away”. Parkside is currently involved with the ‘End of Life’ care initiative and is completing, with the assistance of the residents and relatives, ‘preferred place Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 13 of care’ care plans. Some of the staff have already attended training and the manager is part of the local steering group on ‘End of Life’. The home currently has a resident who has expressed her wishes to remain in the home. The care staff, the community nurses, GP and relatives are all working together to ensure that her wishes are met. The relative stated, “They are all doing a wonderful job”. The manager and staff are to be commended on the work they are doing towards residents’ End of Life’ care and a score of 4 (commendable) has been given in recognition of this. There are policies and procedures for the administration and recording of medication, guidance on homely remedies and guidance on action, should an error occur in the administration of medicines policy and procedure. Only senior staff can administer medication and whilst they are administering medication they wear a red tabard; this is to ensure that residents do not talk to the member of staff and thus decreasing the likelihood of the wrong medication being administered. Medication Administration Records (MAR) were examined and though there was a high standard of compliance, the manager must ensure that when a change in the dosage of medication is advised, or if medication is discontinued, that the care staff state on the MAR sheet the name of the health care professional who advised the change and date and sign it. This is Requirement 1. The inspector spoke to a number of residents who all said that staff treated them with respect and were sensitive to their feelings when undertaking personal care. One resident stated, “I am quite content, they are very kind”, another resident stated, “I am so happy here, they really look after me”. A relative stated “ I am more than happy with the care the staff give my Mum, they treat her with respect and are sensitive to her needs”. Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 14 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 and 15 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The activities programme is limited and this needs to be more varied and tailored to meet the residents’ individual needs and preferences. Visiting times are flexible and people are made to feel welcome when visiting the home. This ensures that residents are able to maintain contact with their family and friends as they wish. Residents are able to exercise choice and control over their lives. The meals in the home are very well presented and nutritionally balanced and they offer both choice and variety to the residents. Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 15 EVIDENCE: Residents were asked their views, and care plans and other records were examined. Both the Annual Quality Assessment and records kept at the home show a limited activities programme. Satisfaction questionnaires that had been completed by residents and relatives also showed that the main issue was a lack of activities within the home and in the community. The inspector spoke to a number of residents and comments were “I would like to go out more”, “we were due to have a trip out in the minibus but that was cancelled”, another resident stated, “I would like to be taken to the park, I use to spend a lot of time there”. Current activities include: church services twice a week, communion once a month, keep fit every two weeks, weekly quizzes or discussions on current affairs and a social evening once a month and a hairdresser visits twice a week. In June the local primary school came to the home and gave a concert and there is also a Christmas party. Many of the residents have a daily newspaper and one resident enjoys doing the Daily Telegraph cryptic crossword and another resident enjoys knitting. The residents also enjoy an informal weekly meeting with the administrator, minutes of the last meeting showed that topics that were discussed included; staff dress code and keep fit sessions. Some of the residents are able to go out independently to the shops, to the bank, to visit friends and to their church. Some of the residents go out with their families and one resident was getting ready to go and stay with her daughter in Wales. All of the residents have a celebration tea on their birthday; one of the residents recently celebrated his 100th birthday, he now joins three other residents who are over 100 years old. The residents of Parkside have varying levels of independence and the practical support they require and receive is clearly recorded in their care plans and daily records, therefore it does not mean that ‘one size fits all’ in regard to their needs and wishes regarding their social activities. The home, which has it’s own mini bus is situated in central Romford and there are many activities in the local community that could be explored. The inspector had a discussion with the manager regarding this issue and she advised the inspector that they are looking at the possibility of employing a part time activities co-ordinator. However the manager does need to look at developing a more person centred activities programme. This was a previous Requirement that has been set with a new timescale. This is Requirement 2 Visiting times are flexible and visitors confirmed that they could visit at any time. Residents have the choice as to where they see their relatives and friends, either in one of the lounges, the garden or their own bedroom. The signing-in book indicated that there is a steady stream of visitors to the home. Relatives stated that they were always made to feel welcome and offered a cup of tea. One relative stated, “we always feel very welcome and the grandchildren enjoy visiting”, another relative stated, “I enjoy visiting Mum, I know she is very well looked after”. Indeed on the day of the Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 16 inspection there were a number of young children visiting the home, which the residents appeared to enjoy. Residents’ care plans indicate their preferred name and their wishes regarding their death. Residents are encouraged to bring into the home some of their own personal possessions and this was evident when the inspector visited residents’ bedrooms. Residents’ meetings are taking place and are involved with some of the decision-making within the home such as, menu planning, staff dress code and part of the interviewing process for prospective staff. Every resident holds their own bedroom key and some of the residents take responsibility for their own finances and medication and, as well as their bedroom door key, they also have a side door key to the home. Meals are mostly served in the dining room, though residents can take their meals in their bedroom of they so wish. A visit was made to the kitchen, which has recently been refurbished with stainless steel units and was able to discuss menus and the storage and preparation of food with the cook. There is four week rotating menu, which the residents had been involved with planning. The cook was aware of the special dietary needs of the residents, such as gluten free bread and cakes for one resident and their likes and dislikes. On the day of the inspection the lunch was; homemade steak & kidney pie with fresh cabbage, cauliflower and mashed potatoes followed by stewed apples, blackberries and custard. The inspector took lunch with the residents and the meal was beautifully cooked and presented; all of the vegetables were served in terrines and the gravy was served in a gravy boat, this enabled residents to have choice as to what they wanted and the quantity. The residents had assisted in drawing up the menus and though there was not a second choice on the menu, the cook confirmed that she would always serve an alternative. Indeed for the day after the inspection one of the residents had requested chicken, which the cook had in the refrigerator. The refrigerators, freezers and store cupboards were amply stocked with an abundance of fresh fruit and vegetables and all pies and puddings are homemade. There were also two bowls of fresh fruit in the hallway for residents to help themselves to. There was evidence that refrigerator and freezer temperatures were being appropriately recorded. Residents and relatives that were spoken to were very complimentary of the food. Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 17 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 and 18 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Residents and relatives can be confident that their complaints will be listened to and acted upon. There are policies and procedures on safeguarding adults and staff have undertaken training, which ensures there is an appropriate response to any allegations or concerns regarding safeguarding adults. EVIDENCE: The home has a satisfactory complaints procedure in place. This is displayed in the main hallway and the Service User Guide. The complaints book was examined and there have been two complaints since the last inspection. Both of these complaints had been dealt with appropriately and to the satisfaction of the complainant. Residents were asked “if you were unhappy about anything in the home, who would you complain to”? Most of the residents stated, “They would talk to Gillian (manager)”. One resident said she would “Tell my daughter”, another resident stated, “I have never had to complain but I know that if I did, Gillian would see to it straight away”. All of the residents, barring two, have family/friends who are in regular contact and people from the local Baptist Church visit the remaining residents. Relatives that were spoken to said that they would talk to Gillian or in her absence either Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 18 the deputy manager or the assistant manager, and felt very confident that their complaint or concern would be listened to and acted upon. The inspector is satisfied that the manager would and has acted promptly on any concerns or complaints. Some of the residents administer their own finances, whilst others receive assistance from relatives or solicitors. The home holds small amounts of money for hairdressing, chiropody, newspapers and other small sundries. Residents’ monies were checked and all were found to be accurate with receipts tallying with the amount of money spent. There is a written procedure and policy for dealing with safeguarding adults. The home has a copy of the local authority (London Borough of Havering) documentation on safeguarding adults. Staff that were spoken to were aware of the actions to be taken if there were any concerns regarding the safety and welfare of the residents. Safeguarding adults training is seen as a high priority by the manager and this topic is covered during staff’s induction programme, further training with the local authority has also taken place and this important topic is also discussed at staff meetings. The Commission for Social Care Inspection has received no complaints, concerns or allegations about the service since the previous inspection. Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 19 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): 19,20,21,22, 23,24,25 and 26 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home is very welcoming and provides the residents with a clean, safe and comfortable environment in which to live. There are sufficient and suitable toilets and bathrooms to meet the needs of the residents. Bedrooms are comfortable and furnished with some of the residents’ own personal possessions. EVIDENCE: The home has a very homely and welcoming atmosphere. A tour of the home was undertaken and all areas of the home were inspected including the kitchen, storerooms and laundry room. There is a daily and weekly cleaning programme for the kitchen and laundry, both of these rooms were maintained to a very high standard. The kitchen has recently been refurbished with new Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 20 stainless steel fixtures and fittings; refrigerators and freezers were very well stocked and appropriately stored with a good supply of fresh vegetables and fruit. Records were examined and refrigerator and freezer temperatures are being regularly recorded. The home has an ongoing redecoration and refurbishment programme, currently the annexe at the back of the house is being extended and refurbished; when completed (November 2007) the annex will consist of 5 single en-suite bedrooms and a conservatory. This part of the home will be for residents with higher care needs (not nursing). All of the living areas and the hallways were clean, appropriately furnished and have been decorated to a high standard. The living area of the home currently consists of two large lounges at the front of the house; one of these lounges has been designated as a ‘quiet room’ and a conservatory at the back of the house, which is used as the third lounge. There is a separate dining room, which has a number of small tables for residents to sit at. All of tables were laid with place mats, coasters and napkins; this coupled with the seating arrangements gave the dining room a homely feel. One of the residents stated, “It is a real pleasure to sit and eat our meals in such a nice dining room”. All of the bedrooms were found to be very clean, free from any offensive odour and nicely decorated and appropriately furnished. The inspector was advised that when a room becomes vacant, it is redecorated, and a new vanity unit and furniture are installed. Indeed on the day of the inspection the maintenance manager was completing the refurbishment on one of the bedrooms. Most of the bedrooms are single and either have ensuite or wash hand basin facilities, there are two double bedrooms; one of these is currently being shared by a married couple. All of the bedrooms are personalised with residents’ own furniture, such as, coffee tables, armchairs, a writing bureau, as well as televisions, radios, photographs, pictures and ornaments. For those residents who have high care needs; specialist mattresses and hoists are available, which ensure the safety and comfort of those residents. One resident stated, “ I really like my room, I was able to bring some of my bits and bobs, which makes it feel more like home”, another resident stated “I love sitting in my room and listening to the radio”. There are sufficient toilets and bathrooms on both floors; there are four bathrooms; two baths are adapted, the other is a standard bath and the fourth is a shower room. Handrails have also been fitted in the toilets to assist residents with mobility and transferring problems. The gardens are well maintained and have a nice sitting area, the front garden has been redesigned and the front of the building has been repaired and redecorated. The repair work has involved replacing over 100 foot of timber on the facia of the building, restoring some of the stonework and cleaning the gutters. Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 21 There are at least three domestics a day Monday-Friday and one at the weekends. As stated earlier the home is currently undergoing a refurbishment programme and this must have caused extra work for the domestic staff, however on the day of the inspection the home was spotlessly clean and tidy. There are adequate control systems in place to ensure that the home is free from any offensive odours. Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 22 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 and 30 People who use this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home’s staffing levels are satisfactory and there are sufficient staff on duty that have the appropriate skills and training to meet the needs of the residents. The home has a clear recruitment policy and procedure and appropriate checks are undertaken. However the application form needs to be amended to obtain more specific information on an applicant’s history to ensure that residents are protected at all times. EVIDENCE: Staff rotas were examined and the rota correlated with the number of staff on duty, during the morning there are at least three care staff (rising to five during the morning when the annex is completed), at least one of the staff is a senior and/or assistant manager and two waking night staff, as well as the manager and deputy manager who are supernumerary to the rota. Other staff includes an administrator, housekeeper, cooks, kitchen assistants, domestics, a maintenance manger and a gardener. The home has extremely good staff retention with many of the staff having worked at the home for fifteen or more Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 23 years. Staff sickness levels are also satisfactory. The home is almost fully staffed and on the day of the inspection there were sufficient numbers of staff on duty to meet the needs of the residents. Two files of the most recently employed staff were examined and both showed that all relevant recruitment procedures had been adhered to. All files had a completed application form, however the inspector discussed the application form with the administrator and the manager, as the form is fairly limited in the information required; no information is required regarding the applicants educational achievements or the Rehabilitation Offenders Act. The administrator showed the inspector an example of another application form, which was more appropriate. This is Recommendation 1. All staff files had two written references; satisfactory Criminal Records Bureau checks and copies of proof of identity were also available. Normally two members of staff and a resident are involved with the interviewing process and in keeping with equality and diversity all candidates are asked the same questions and their answers are recorded. This is commendable practice and a score of 4 is given. All newly appointed staff undertake an induction programme that is in line with the Skills for Care Council. Topics covered during the induction period are; moving and handling, first aid, understanding the principles of care, recognising and responding to abuse, equality & diversity, communicating effectively and maintaining safety at work. Other training that has been undertaken in the past nine months includes: COSHH (Control of Substances Hazardous to Health), 4 day course and 2 day refresher course in first aid, risk assessments, Mental Capacity Act, infection control, lifting & handling, needs of the resident, safeguarding adults (previously known as protection of vulnerable adults), care planning, introduction to ‘end of life’ care, principles of person centred care, role of the care worker, fire prevention in the care home and food & hygiene. The manager and some of the staff are undertaking a distance-learning course with Hackney College in ‘The safer handling of medication’; the National Certificate of Further Education certifies this course. There are 24 permanent care staff and the manager. More than 50 of the care staff have NVQ2/3; 5 care staff commenced their NVQ2 this month (September), 6 care staff have NVQ3 and another 4 care staff have commenced this course within the past six months. A planned training programme is now in place and the manager is working closely with the local authority and other training venues regarding future training for all of the staff. The manager has shown a strong commitment to staff training and ensured that it is seen as a high profile by the staff. This has been appreciated by the staff, as comments received were, “I was nervous about doing the NVQ3 but I really enjoyed and learnt a lot from it”, “I have been on the introduction to ‘end of life’ care and I think it has made a difference to the way we have cared for residents at the end of their life”. This is commendable practice and a score of 4 is given. Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 24 Staff that were spoken to all stated that they very much enjoyed working at Parkside, two of the staff stated, “I feel privileged to work here”, other comments were, “we all work together as a team”, “I have worked here for seventeen years and I still enjoy coming to work”. Residents’ comments were very complimentary of the staff, “they are absolutely marvellous”, “they are all angels, always have a smile and time for a chat”, “we are truly blessed with the people that work here”. A relative stated, “the staff are lovely, we are made to feel so welcome”. Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 25 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): 31,33,35,36 and 38 People who use thus service receive good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home is managed by a qualified and experienced manager who has sound management practices, this means that residents’ health, safety and welfare are promoted and protected. Residents can be confidant that their views underpin the self-monitoring, review and development of the home and that their financial interests are safeguarded by the policies and procedures of the home. Residents’ and staff health, safety and welfare are promoted and protected. There is a system in place to ensure that staff receive regular supervision and yearly appraisals. Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 26 EVIDENCE: Parkside has a registered manager who is suitably qualified; she has recently gained her Registered Managers’ Award and has many years experience of working in care homes. She is committed to providing and improving the quality of care at the home, to achieve this she works closely with health and social care professionals and the Commission. She has responsibility for the financial budget of the home and is aware of her budgetary limitations. In discussion with the administrator and the manager it is clear that the home has effective and regular support from the Parkside Housing Committee and there are clear lines of accountability. The manager is also a member of the local steering committee group on ‘preferred place of care’ and ‘flu pandemic’. Discussions with the manager showed she was able to describe a clear vision of the home based on the values and ethos of Parkside, which is part of the Romford Baptist Church Housing Association. It was evident that she was able to communicate a clear sense of direction and demonstrated a sound understanding and application of good practices particularly in relation to continuous improvement of the service. The manager has visited the home ‘outside of normal hours’ and this is supported by regular supervision of all the staff and other quality monitoring systems, such as, residents’ meetings (both formally and informally) and feedback from relatives. However the manager and the Housing Committee need to carry out a quality assurance survey involving all the residents, relatives and stakeholders (funding authority) and from the results develop an annual development plan (which should include the 5 year building development plan), which reflects the aims and outcomes for the residents. This is Requirement 3. Under the requirement of Regulation 26 of the Care Home Regulations the registered provider is required to carry out monthly visits to review the quality of the service, and reports of these visits should be made available to the Commission. These comprehensive reports are sent to the Commission on a regular basis. During the course of the inspection the manager was observed leading from the front, by directly engaging with the residents and staff. There was also a high level of praise from the residents and staff and it was evident from her interaction with the residents that they enjoyed her company. Comment from residents were, “Gillian (manager) is wonderful, nothing is too much trouble”, “she is a lovely lady, she always has time to talk”, “Couldn’t ask for anyone better, she is the tops”. Staff were also complimentary of the manager stating, “Gillian is a brilliant manager, she always has time for us”, “She is very supportive and has organised a lot of training, we have been very lucky”. Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 27 The home has appropriate policies and procedures regarding the safeguarding of residents’ finances. Many of the residents are responsible for their own finances and relatives support those that are not. The home holds small amounts of money for some residents to pay for hairdressing, chiropody and newspaper and other small items. Residents’ accounts that were checked were correct and showed that sound financial procedures were being followed. From discussion with the manager and staff it was evident that staff supervision is taking place six times a year, as well as yearly staff appraisals and regular staff meetings; these meetings are broken down into separate meetings- management, senior carers, carers, domestics, night carers and cooks. The home has a maintenance manager who was able to evidence that all health and safety checks are taking place. He proactively monitors the home’s health & safety performance and consults other experts and specialist agencies when necessary. Risk assessments were in place for fire, first aid, infection control and moving and handling. The maintenance manager undertakes daily, weekly, monthly, quarterly and yearly checks on the fabric and contents of the building and there was written evidence that any repairs are dealt with speedily. Refrigerator and freezer temperatures are taken daily and all opened food that was stored was covered and dated. Fire drills are regularly taking place and recorded and fire detection and fire extinguishers were serviced in September 2006. Safety and maintenance certification for equipment and fixtures in the home were randomly inspected and all were found to be in good order. The manager is notifying the Commission of all serious incidents, hospital admissions and death of a resident via Regulation 37 notifications. Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 28 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 3 X 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 17(1) Requirement The registered manager must ensure that all changes in residents’ medication are signed and dated and include the name of the person who instructed the change. The registered manager must consult with residents about their social interests and arrange a programme of activities based upon this consultation. Previous timescale of 30/09/06 not met. The registered manager must continue to develop the quality assurance programme and the findings fed into a development plan for the home. Timescale for action 30/09/07 2 OP12 16(m&n) 30/11/07 3 OP33 24 (1) 31/12/07 Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 30 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 OP29 Good Practice Recommendations The application form needs require information on the applicants educational achievements and the Rehabilitation Offenders Act. Parkside DS0000027871.V349601.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Text phone: 0845 015 2255 or 0191 233 3588 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 DS0000027871.V349601.R01.S.doc Version 5.2 Page 32 - 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!