CARE HOMES FOR OLDER PEOPLE
Parkside Care Home Parkside Care Home 280 Prescot Road St Helens Merseyside WA10 3AB Lead Inspector
Mrs Lynn Paterson Unannounced Inspection 2.45pm 11 November 2005
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 Care Home DS0000046213.V256464.R01.S.doc Version 5.0 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 Care Home DS0000046213.V256464.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Parkside Care Home Address Parkside Care Home 280 Prescot Road St Helens Merseyside WA10 3AB 01744 22821 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) Parkside (St Helens) Ltd Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Parkside Care Home DS0000046213.V256464.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. Service users to include up to 30 OP The service should, at all times, employ a suitably qualified and experienced manager who is registered with the CSCI An application for a manager should be submitted to the CSCI by the 20th May 2004 nDate of last inspection Brief Description of the Service: Parkside Care Home is registered to provide care for 30 individuals of the category old age. The home is located in St. Helens, Merseyside and is situated on a main road location in a residential area close to local amenities and has good links to public transport. The premises presents as a large detached property with bedroom accommodation being provided on the ground and upper floor. The home offers spacious communal rooms for residents and pleasant garden areas. Car parking is available to the front of the premises. Parkside Care Home DS0000046213.V256464.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection of Parkside Care Home was carried out on the afternoon of 11th November 2005 and the visit was undertaken on an unannounced basis. For the purpose of this report 5 staff and 19 residents were spoken with and the inspector carried out a partial tour of the premises. 2 care plans, staff rotas, staff training programmes, care files and daily records were examined and staff were observed carrying out their role. The inspector was assisted by the quality manager and was advised that the home did not have a CSCI registered manager in place at this time. Some documentation requested was not available at the time of the visit the reason given was that the homeowners had locked them away and were not on site to provide access. The findings of this inspection are recorded below: - What the service does well:
During the visit it was noted that the residents appeared to be content and comfortable in the home and most residents spoken with confirmed that they felt “safe and at home” within Parkside. Residents said that staff were kind and helpful and provided good care. Staff observed carrying out their care practices showed they treated the residents with respect and enjoyed good interaction. The home presented as clean and hygienic at the time of the visit. Staff spoken with, were able to evidence that they had received all the mandatory training pertaining to care practices, and most staff advised that they had been provided with extra training in other areas of care which they felt had been most useful. Staff appeared to work well together and those spoken with confirmed that they enjoyed each others company and worked as a team. Parkside Care Home DS0000046213.V256464.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better:
It was noted that pre admission assessment documentation was held on file together with plan of care however neither document had clear information about a needs led assessment or of how care was to be delivered. Discussion with staff revealed that they were uncertain as to what information was needed on care planning documents. Care plans viewed did not hold signatures to evidence that they had been drawn up in partnership with the resident and their representative. Residents spoken with were not aware of the careplanning document or of the care reviewing system in the home. It is recommended therefore that all care plans are reviewed and updated as required to ensure that all needs are identified and recorded and signatures obtained to show that they have been developed in partnership with the resident. Residents spoken with said that whilst they enjoyed being at Parkside they wished that the home would arrange more activities and interest for them. Comments made from residents included” we like it here because we have made friends with each other and can have a laugh but we wish we had more activities”, ”we used to have more activities than we have now”, ”we have some things going on like bingo and keep fit but I wish we had more”. “ WE are ok here, we just make our own fun”. Discussion with staff revealed that the home do arrange activities such as keep fit and bingo and have some in house entertainment however staff were unable to provide a daily or weekly programme to evidence that activities are offered on a regular basis. It is recommended therefore that the home provide a daily lifestyle for residents that matches their expectations and preferences and satisfies their social and recreational interests and needs. Whist the home appeared to be running smoothly at the time of the inspection visit, records show that the home is without a manager who has been approved and registered with CSCI. The quality manager was unable to answer some questions or provide some information necessary to measure standards, as she was not the registered person in charge of the home. As a consequence the inspector was not fully able to complete her inspection. It is a requirement therefore that the home- owners submit a managers application which is followed through to CSCI fit person interview and subsequent approval. Parkside Care Home DS0000046213.V256464.R01.S.doc Version 5.0 Page 7 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 Care Home DS0000046213.V256464.R01.S.doc Version 5.0 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 Care Home DS0000046213.V256464.R01.S.doc Version 5.0 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Pre- admission assessments are carried out by staff, however the information obtained appears inconsistent and does not fully assess need. EVIDENCE: The inspector looked at 2 recent pre- admission assessments and noted that they did not include full detail of need. The documentation was in tick box form and did not give information about abilities or required care practices and as a consequence could not evidence that the home could assure that needs would be met. The 2 assessment documents examined held differing amounts of information with one addressing a potential serious risk but not having a risk assessment in place. The staff member who had completed the assessment on this occasion had identified the potential risk and merely asked the residents family to sign a disclaimer that this risk may occur and the home would not be responsible for any harm or damage to the resident. Discussion took place as to who was responsible for admission and assessment and it was eventually agreed that the home should not offer placements to any resident if they felt that the home or room was not suitable to meet needs. Staff advise that due to the fact that the home is functioning without a registered manager most of the senior staff are involved in undertaking pre admission assessments depending who is on duty at the time of the request.
Parkside Care Home DS0000046213.V256464.R01.S.doc Version 5.0 Page 10 It was recommended therefore that all staff responsible for this task be made aware of the responsibilities of this standard. Parkside Care Home DS0000046213.V256464.R01.S.doc Version 5.0 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7.10. Care plans are in place however they do not clearly set out details of individual care delivery. Residents are treated with respect by well- trained staff. EVIDENCE: The inspector examined 2 care plans and noted that they did not hold full details of the individual care delivery. The care plans were in a tick box and number form and were not explicit in the detail of how care should be provided and when care was needed. The care plans did not hold any signatures to show who had been involved with their development. Residents spoken with were not aware of the existence of a care plan and were not aware of what care practices had been arranged. Staff spoken with advised that they carried out their care practices generally by discussion with residents during the time when providing assistance and did not refer to the care plans very much. The inspector advised that the care plan was a necessary document which was to be used to make sure that the care provided is as agreed by all concerned and this plan should be monitored and reviewed to make sure that any changing needs are identified and addressed. Parkside Care Home DS0000046213.V256464.R01.S.doc Version 5.0 Page 12 Staff observed during the inspection showed that they interacted very well with residents and used discreet methods of assistance to make sure that residents maintained their dignity and privacy at all times. These practices were seen to be commendable. Parkside Care Home DS0000046213.V256464.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 12 The home arrange activities and interests for the residents, however it would be beneficial if this could be extended to ensure that the lifestyle in the home meets the expectations and preferences of all residents. EVIDENCE: The quality manager advised that she edited new letters for the residents that held detail of activities and events which were due to take place in the home. She was able to produce some of these news- sheets, which identified that some activities had taken place. However staff were unable to provide any posters to show that daily activities occurred in the home. Residents spoken with said that activities were in place to include keep fit and bingo and they sometimes had sing a longs but they felt that they needed more activities to be arranged to enable them to have choices in their daily living. Comments included “we have some activities but not enough”, “we used to have more activities in the past but now we have things like bingo and keep fit but we would like more to keep us going”, ”we don’t do much here, we talk to each other and have our visitors but not much else”. Care files viewed did not evidence that daily activities were in place. It is recommended therefore that the home consult with the residents to make sure that the lifestyle in the home matches the expectations and preferences of the residents in their care.
Parkside Care Home DS0000046213.V256464.R01.S.doc Version 5.0 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 the following standard(s): The standards in this section were not measured at this time. EVIDENCE: Parkside Care Home DS0000046213.V256464.R01.S.doc Version 5.0 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 the following standard(s): 19 Residents live in a safe environment, which is clean, hygienic and well maintained. EVIDENCE: A tour of the communal areas of the home identified that the location and layout was suitable for its stated purpose and the quality manager advised that she had records on file that identified the building complied with the requirements of the local fire service and environmental health department. Documentation viewed showed that the home maintenance person dealt speedily with all routine maintenance work and it was noted that the home was well maintained to include all fabrics and furnishings and was clean and hygienic at the time of the unannounced visit. During the visit it was noted that the ceiling area of a small front lounge was experiencing water damage from a leak. Staff advised that this had occurred that day and as a consequence they had cordoned off the area and were awaiting the arrival of a contractor to deal with the problem. The grounds of the home were pleasant, well managed and accessible to residents at the time of the visit.
Parkside Care Home DS0000046213.V256464.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The home provides well- trained and motivated staff in sufficient numbers and skill mix to meet the needs of the residents. EVIDENCE: The staff rota showed that the home employs staff in sufficient numbers and skill mix to meet the needs of the current residents of the home. At the time of the inspection 4 care staff a quality manager a cook and a cleaner were on duty in the home. 27 residents were accommodated in the home and those who were spoken with said that staff were kind, caring and looked after them well. All staff interviewed revealed that they were well trained, knowledgeable and motivated to provide good quality care to the residents of the home. Staff also identified that they respected each other and worked together in harmony. Observations of staff carrying out their remit evidenced that they enjoyed good interactions with residents and their representatives and created a most homely and pleasant environment. Parkside Care Home DS0000046213.V256464.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The home is currently without a registered manager and some documentation was unavailable for inspection at the time of the visit, therefore no standards have been measured in this section. However the registered provider must ensure that a manager’s application is forwarded to CSCI within the next ten days to enable the registration process to commence EVIDENCE: Parkside Care Home DS0000046213.V256464.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 3 x X X X X X X STAFFING Standard No Score 27 4 28 X 29 X 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X X X X Parkside Care Home DS0000046213.V256464.R01.S.doc Version 5.0 Page 19 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 OP3 Regulation 14 Requirement New service users must only be admitted after a full needs led assessment to identify if the home can meet all assessed need. This must hold risk assessments and detail how the home will manage any assessed risk. A service user plan of care is drawn up with the service user to show how needs led care will be delivered. This must identify how the home will meet resident’s needs and choices and hold signatures of all parties involved with the compilation of the plan. The home must have a qualified and experienced manager who is registered with CSCI. The registered provider must make application with the relevant fee to CSCI by the date stated in the timescale for action column of this document. Timescale for action 12/12/05 2 OP7 15 12/12/05 3 OP31 8.9. 25/11/05 Parkside Care Home DS0000046213.V256464.R01.S.doc Version 5.0 Page 20 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 OP12 Good Practice Recommendations It is recommended that consultation is ongoing with residents and their representatives regarding the provision of social activity, which meets residents individually assessed needs and preferences. It is recommended that all staff are provided with information pertaining to the development and reviewing of care plans to enable them to obtain information that may be useful when delivering, monitoring and reviewing care. It is recommended that all staff who hold responsibility for pre assessments of prospective residents are provided with details of the full requirements of standard 3 and Regulation 14. 2 OP7 3 OP3 Parkside Care Home DS0000046213.V256464.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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