CARE HOMES FOR OLDER PEOPLE
Parkside Care Home Parkside Care Home 280 Prescot Road St Helens Merseyside WA10 3AB Lead Inspector
Daniel Hamilton Unannounced Inspection 3rd July 2007 08:45 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.V337320.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 Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Parkside Care Home Address Parkside Care Home 280 Prescot Road St Helens Merseyside WA10 3AB 01744 22821 0161 9294148 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 Mrs Glenda Gould Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Parkside Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Service users to include up to 30 OP The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 12th May 2006 Date of last inspection Brief Description of the Service: Parkside is a large detached Victorian House that has been converted into a Care Home and is registered to provide personal care and support for up to 30 older people. 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 and shops. The property enjoys a pleasant view of the park and Grange Park Golf Course to the rear. The home offers three lounges with televisions, a sitting room, small library and a dining room. The premises has 22 single bedrooms and four double rooms. Toilet and bathing facilities are located throughout. The first floor rooms are accessible via a passenger or stair lift and a call bell system is in place. There are two large, well-maintained and accessible gardens to the rear of the building and car parking is available to the front and side of the premises. Care Home Fees range from £361.00 to £391.00 per week. Parkside Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced ‘Key’ inspection took place over one day and lasted approximately 8.5 hours. A partial tour of the premises took place and observations were made. A selection of care, staff and service records were also viewed. The inspectors met with the Owner / Manager, care staff, residents and relatives who were visiting the home during the visit. Care Home Survey forms were also distributed to a number of residents and / or their relatives prior to the inspection, to obtain additional feedback about the home. All the core standards were assessed and action taken in response to previous requirements and recommendations from the last inspection in May 2006 was reviewed. What the service does well:
Feedback received from residents and / or their representatives was generally positive regarding the quality of care provided. Comments included; “I am happy with all aspects of care”; “I’ve chosen the right home” and it’s a nice place to live.” The home had developed an assessment and care planning system to ensure the needs of residents were identified and planned for. Risk assessments had been produced to identify and control potential risks and additional records were maintained to account for the general care and support provided to residents. Staff spoken with demonstrated a good awareness of the needs of residents and were observed to offer support to residents in a respectful and sensitive manner. Comments received from residents included; “I am looked after very well”; “The carers are thoughtful in their approach” and “The staff are very nice indeed”. A general practitioner reported; “The staff generally appear very caring to individuals.” Residents reported that they had access to health care service and records were available to confirm the outcome of appointments with various health care professionals. Evidence was also available on files to confirm that referrals had been made to general practitioners and the falls prevention service for people with a history of falls. A programme of activities had been developed that was based upon the recreational needs of the people living in the home. Residents confirmed they
Parkside Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 6 were generally satisfied with the activities provided. One resident stated there are “Really excellent activities” and another resident said; “I enjoy the exercises and theatre trips.” Residents were encouraged to exercise choice and control over their lives and the people living in the home were able to receive visits from family and friends at any reasonable time. A resident said; “There are no restrictions. My family can visit any time.” Meals were well managed and residents received a choice of nutritious and wholesome meals. Comments received from residents included; “The food is very good. There is a good choice”; “There is plenty to eat. You are never left hungry” and “The food is excellent. We are having hot pot today.” The home had a satisfactory complaints procedure and safeguards were in place to protect people from abuse. Systems had also been established to consult residents about the quality of care provided and to monitor standards within the home. Areas viewed within the environment were well maintained and the home continued to receive ongoing investment. One resident said; “They [Owners] make a great effort to provide an uplifting environment.” Likewise, the relative of a resident reported; “The residents’ personal care is excellent, as is the cleanliness and the upkeep of the home.” What has improved since the last inspection?
Since the last visit, the home had taken action to ensure information on daily living and social activities had been obtained as part of the assessment process. Care Plans had also been produced for all residents in order to identify the individual needs of residents and the action required by care staff. A risk assessment had been completed for a resident who self-administered medication, to ensure the welfare of the resident was protected. Training records had been developed for each member of staff and documentary evidence of training completed and / or qualifications had been obtained for reference. Good progress had been made in supporting staff to achieve National Vocational Qualifications and training in Infection Control and Safe Working Practice topics. Recruitment records were available for inspection for staff recruited since the last visit. An electrical wiring certificate had been obtained to confirm the electrical wiring installation was safe and fire drills had been recorded to provide evidence that staff had participated in fire training. Furthermore, the hot water
Parkside Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 7 outlet in a bathroom had been correctly regulated to minimise the risk of scalding. The Registered Manager had registered to undertake a National Vocational Qualification in Care at level 4 and was in the process of working towards the award. The home had continued to receive investment in order to improve the environment for residents. What they could do better:
Records showed that staff had commenced employment in the home before two satisfactory references had been obtained. This practice must stop in order to protect the welfare of the people using the service. Some residents reported that they did not receive information on the service prior to admission and some admission checklists were incomplete. The home should review how information is shared with residents and / or their representatives so that have the necessary information to make an informed decision about where to live. Care files remained difficult to case track as they contained forms that were not being used and there was duplication of some records. Furthermore, care plans viewed had not always been signed by residents and / or their representatives to confirm they were in agreement with their plan of care. Action should be taken to address these issues in order to improve record keeping and accountability. It is also recommended that the home maintains a record of regular observations of residents who have fallen during the day and / or night to ensure best practice. Although a risk assessment had been completed for a resident who selfadministered medication, there was no information on the medication the resident was taking. This should be addressed, to protect the interests of the resident and to improve risk assessment practice. It is also recommended that the Registered Manager assess the competency of staff at regular intervals, before they are expected to handle and / or administer medication. This will help to reduce any possibility of recording and / or administration errors. Although the Registered Manager has previously completed the National Vocational Qualification level 4 Registered Managers Award, a certificate was never received due to the training provider ceasing to operate as a business. The manager should make alternative arrangements to complete the award / obtain a certificate, to ensure she has the necessary qualifications for her role. Parkside Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 8 The manager should also record the details of the hours she works in the home on the rota, to improve record keeping and accountability. Arrangements should also be made to maintain written records of formal staff supervision. 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 Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 9 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.V337320.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents and their representatives do not always receive the necessary information to make an informed decision on the home. EVIDENCE: Parkside displayed a range of information for residents, which was available in the reception area of the home. The documents included; a copy of the Statement of Purpose, Service User Guide, previous inspection reports, annual satisfaction survey findings and information on comments, compliments and complaints. A ‘Service User Admission Checklist’ had been developed to confirm residents and / or their relatives had been informed of where to find information on the home and received a copy of the terms and conditions of residency. Some checklists viewed had not been dated or were incomplete and some residents reported that they had not received information on the home prior to admission. Contracts had been issued to residents and once signed had been passed to the home’s accountant for safekeeping.
Parkside Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 11 The Annual Quality Assurance Assessment detailed that home had developed policies and procedures for referral and admission. Six files were selected to view during the visit. The inspectors concentrated on residents with different needs and who were self funding and / or with a history of falls. Each file contained a ‘Daily Living and Needs Assessment’, which had been completed by a senior member of staff prior to the admission of each resident. The assessments documentation was generally well constructed and contained key information on the needs of residents including health care needs and history of falls. Equality and diversity issues i.e. ethnicity and gender had not been included in the home’s assessment documentation. This issue was discussed with the manager during the visit. The manager demonstrated a commitment to promoting equality and diversity issues within the workplace and to meeting the diverse needs of all residents. Parkside Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 12 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that residents receive is based upon their individual needs and the principles of respect, dignity and privacy are put into practice. EVIDENCE: Six files were selected to view during the visit. The inspectors concentrated on residents with different needs and which included people who were self funding and / or with a history of falls. Each file examined contained a care plan, which outlined the action required by staff to meet the health, personal and social care needs of residents. Care plans seen had generally been kept under monthly review although some plans had not been signed by residents or their representatives. Likewise, some residents spoken with were not aware of the content of their care plans. These issues had also been noted at the previous inspection. Files also contained a range of supporting documentation including; personal profiles, family tree, daily routines, likes and dislikes, daily living plans, person centred risk assessments, daily report sheets, weight records and accident report and description forms. Records showed that the home had made
Parkside Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 13 referrals to general practitioners and / or the falls prevention service for residents at risk of regular falls. Staff spoken with demonstrated an awareness of the need to monitor residents after incidents of falling. The manager was advised to record regular observations of residents following falls, to further improve practice in this area. Due to the large amount of information on file, some care plans were difficult to follow and there appeared to be duplication of records as previously noted Some records were in need of review as they had not been dated or signed. Feedback received from residents via Care Home Survey forms and discussion confirmed the people living in the home had access to medical support subject to individual needs. Records viewed showed that residents had received visits from general practitioners, opticians, physiotherapists, district nurses and chiropodists. The home had a Medication Policy and Procedure in place, which included procedures for residents who wished to self-administer their medication. A copy of the Royal Pharmaceutical Guidelines was also available for staff to reference. Staff responsible for administering medication had completed external medication training. At the time of the visit only one resident was self-administering medication. A risk assessment had been completed since the last visit. The manager was recommended to include a list of medication for self-administration on the risk assessment, to ensure best practice and accountability. Medication was checked with a senior carer during the visit. Medication was found to be appropriately stored and a metal cabinet was available to store controlled drugs. A resident identification system and specimen signatures for staff authorised to administer medication were available for reference. Medication Administration Records (MAR) viewed had been correctly completed to account for the administration of medication however there was no audit trail for some medication, as the date and quantity of medication and the initials of the person receiving medication into the home had not been recorded by a trainee member of staff. The Manager and senior staff spoken with were aware of the requirement to maintain a record of all medication received into the home as previously noted on inspections. The manager was advised to undertake a comprehensive review of the competency of all staff responsible for handling and administering medication at regular intervals, to assess competency and monitor practice. Staff spoken with demonstrated a good understanding of the principles of care and were observed to be attentive and sensitive to the needs of the people living in the home.
Parkside Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 14 Feedback received from residents confirmed they were satisfied with the care provided by staff and that they were treated with privacy, dignity and respect. Comments included; “I am happy with all aspects of care”; “I’ve chosen the right home”; “It’s a nice place to live” and “The staff are very considerate in every way.” Parkside Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 15 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to maintain their independence and exercise choice in relation to daily life, social activities and meals. This enables the people living in the home to lead a lifestyle that satisfies their needs and expectations. EVIDENCE: The home had produced a monthly programme of activities for residents, which detailed a daily activity. A copy of the programme was displayed on the home’s notice board. Activities provided were recorded in a diary, which also detailed the participants and staff responsible for coordinating the event. Activities for the month of July included; craftwork, quizzes, arm chair aerobics, walking in the park, sing-a-longs, bingo, current affairs, reminiscence / memory activities, pamper afternoons, table top games, gardening and music afternoons etc. The home also had a visiting library service and organised entertainment and trips periodically. Feedback received from residents via survey forms and discussion during the inspection confirmed that residents were generally satisfied with the range of activities provided. Comments included; “Really excellent activities”; “I enjoy the exercises and theatre trips” and “Birthdays are celebrated.” Some residents reported that they were also able to receive Holy Communion on a
Parkside Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 16 Sunday and the Senior Carer on duty confirmed that the recreational and spiritual needs of residents were kept under review as part of the assessment and care planning process. The home’s Statement of Purpose and Service User Guide indicated that visitors were welcome at any reasonable time. This was confirmed by residents and a relative during the inspection. A sign was displayed in reception asking visitors to sign the home’s visitor’s book upon arrival and departure at the home. The visitor’s book confirmed that residents were able to receive visitors at different times of the day. The home had a choice of communal areas where residents could meet their friends and relatives. One resident stated; “There are no restrictions. My family can visit any time.” The general atmosphere in the home was warm and friendly and residents reported that they were able to exercise choice and control over their lives and follow their preferred routines. One resident expressed concern that staff in the home had opened a personal letter regarding a hospital appointment. This was brought to the attention of the manager. Residents were able to bring personal possessions into the home and rooms viewed had been personalised with pictures and personal possessions. Files viewed were secured in a lockable cabinet and access to files declaration forms had been completed. Meals were served in the home’s dining room, which was pleasantly furnished. One resident chose to eat their meals in the privacy of their room. Tables were attractively set with tablecloths, condiments and tablemats. Although meals were served at set times, arrangements were flexible to suit individual needs. The home had a rolling four-week menu that offered a range of nutritious meals. The Cook reported that special diets were provided for residents as required. A copy of the daily menu was displayed in the dining room and alternative choices were recorded on a ‘Meal Time Alternatives’ form. The kitchen was well stocked at the time of the visit and temperature and food safety records were being maintained. Feedback received from residents confirmed they were satisfied with the standard of catering and meals provided. Comments included; “The food is very good. There is a good choice”; “There is plenty to eat. You are never left hungry” and “The food is excellent. We are having hot pot today.” Parkside Care Home DS0000046213.V337320.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use the service are able to express their concerns via a complaints procedure and systems are in place to protect residents from abuse. This protects the rights of residents and ensures an appropriate response to suspicion or evidence of abuse. EVIDENCE: Parkside Care Home had developed a Complaints procedure, a copy of which was available in the reception area of the home. Notices were also displayed around the home to inform visitors and residents of the location of the policy. The policy provided information on the process to follow and the timescales involved. The home’s record of complaints detailed that no complaints had been received since the last inspection. One complaint had been received by the Commission for Social Care Inspection. The nature of the complaint concerned Care Planning and Management and Review systems for residents who were / are self-funding; risk assessment and management practices for residents who are at risk of falling; records of visitors to the home and the availability of the Registered Manager in terms of her attendance and presence at the home. No evidence could be found to substantiate the complaints / concerns during the visit. Feedback received from residents and / or their representatives via Care Home Survey forms and discussion confirmed the people living in the home were
Parkside Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 18 aware of whom they could speak to if they were not happy and how to make a complaint. Residents spoken with confirmed they were satisfied with the service provided and that they had no complaints. Comments from two residents included; “Problems I had have been cleared up” and “The manager has genuine concern for the residents.” Previous inspection and Annual Quality Assurance Assessment records confirmed that the home had developed policies and procedures in relation to safeguarding adults and the prevention of abuse. A copy of the Local Authority adult protection procedures was also in place. Training records showed that staff in the home had completed training in the Protection of Vulnerable Adults from Abuse. Staff spoken with during the visit demonstrated an awareness of the different types of abuse and the action required in response to suspicion or evidence of abuse. Parkside Care Home DS0000046213.V337320.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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is well maintained and clean. This provides residents with an attractive and comfortable place in which to live. EVIDENCE: At the time of the visit the home did not have a handyperson. Contractors were hired to maintain the home and grounds as and when required. The Owner reported that he undertook monthly health and safety audits and was responsible for checking the fire alarm system and water temperatures. A ‘Repairs Required’ file was in place for staff to record work in need of attention. The home continued to receive ongoing maintenance and investment. Since the last visit, two bathrooms had been refurbished, the corridors in the older part of the building had been redecorated and thermostatic valves were in the process of being fitted to radiators. The Annual Quality Assurance Assessment completed by the Registered Manager also detailed that filters had been fitted to the washing machine to improve hygiene and infection control.
Parkside Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 20 Issues identified at the last visit had been addressed to improve health and safety practice. Rooms viewed were personalised with personal possessions, pictures and other memorabilia and the fabric and decoration was in good order. The home provided a choice of communal space with opportunities to meet relatives and friends in private. Please refer to the ‘Brief Description of the Service’ section for more information on the premises. Residents had access to personal mobility aids subject to individual need. One resident stated; “They [Owners] make a great effort to provide an uplifting environment.” Likewise, the relative of a resident reported; “The residents’ personal care is excellent, as is the cleanliness and the upkeep of the home.” Records showed that the home employed two domestic staff. Feedback received from residents confirmed the home was always kept clean and fresh and areas viewed during the inspection were clean and hygienic. The laundry was appropriately equipped to meet the needs of the people living in the home. Pre-inspection records detailed that a ‘Communicable Diseases and Infection Control’ and ‘Control of Substances Hazardous to Health’ (COSHH) policies and procedures were in place. Good progress had been made in supporting staff to complete ‘Infection Control’ Training. Staff spoken with during the visit confirmed they had completed training in Infection Control and records showed that eighteen staff had completed training in this key subject since the last visit. Parkside Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 21 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents were supported by appropriate numbers of staff who had access to induction and ongoing training opportunities. Some recruitment practice is in need of review to fully protect the welfare of residents. EVIDENCE: Direct observation, discussion with staff and inspection of rotas confirmed that the staffing levels in the home remained the same as at the last visit. Three care staff and a senior member of staff were on duty through the day with two waking night staff on duty during the night. Ancillary staff were employed for working in the kitchen and for cleaning duties. The Registered Manager and the Assistant Manager were on a course on the day of the visit, however the other Owner was on site. The Registered and Assistant Manager visited the home later in the day to receive feedback on the inspection findings. Staff and residents spoken with during the visit reported that the Registered Manager was present in the home most weekdays and occasional weekends. At the time of the visit the staffing rota did not identify the hours the manager had worked as ‘In’ had been recorded on the rota. The Registered Manager was advised to record her hours worked for future reference. Feedback received from residents and their representatives confirmed the people living in the home received the care and support they required and that
Parkside Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 22 staff were available when needed. Comments included; “I am looked after very well”; “The carers are thoughtful in their approach” and “The staff are very nice indeed”. A general practitioner reported; “The staff generally appear very caring to individuals.” The Annual Quality Assurance Assessment for Parkside detailed that the home had policies and procedures in place for Recruitment and Equal Opportunities, Diversity and Anti-Oppressive Practice. Records detailed that the service planned to extend the involvement of residents in the home’s recruitment process during the next twelve months. The Owner reported that two new care staff had commenced employment at the home since the last visit. Recruitment files were checked for the staff and both were found to contain the necessary records required. It was noted that the two staff members had commenced employment at the home before a second reference had been received. The second reference had been obtained following the date staff had commenced employment in the home. Records were also checked for a staff member, which were not available at the last visit. All the necessary documentation had been obtained. Since the last inspection, the Registered Manager had established new Training files for the staff team. Each file contained a record of the training each staff member had completed, together with documentary evidence of training completed. The home’s training matrix showed that staff had access to a wide range of training that was relevant to their role. The home’s Annual Quality Assurance Assessment detailed that 13 (76 ) of the 17 staff (not including the Registered Manager) had completed a National Vocational Qualification at level 2 or above in Care. Two staff were working towards the award. Staff spoken with confirmed they had completed induction training and certificates were on file to confirm staff had been inducted in accordance with the Skills for Care Common Induction Standards. Advice was given to the Owner and Registered Manager on how to access induction documentation from Skills for Care, as progress logs were not available for reference. Training records showed that staff had completed a range of Safe Working Practice and general training that was relevant to their role. Progress had been made in providing staff with Fire, Moving and Handling and Infection Control training since the last visit. The training matrix highlighted some gaps in training for night care staff e.g. medicines handling, food hygiene and fire training which were brought to the attention of the Manager. Parkside Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 23 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is being developed, to ensure the home operates effectively and is run in the best interest of residents. EVIDENCE: The Manager / Owner (Mrs Glenda Gould) is registered with the Commission for Social Care Inspection. The Registered Manager reported that she had previously completed the National Vocational Qualification (NVQ) level 4 Registered Managers Award in June 2005. A certificate had not been received from the Training Provider (Care Sector Trust), as the Organisation was no longer operating as a business. The manager was aware that she still required a NVQ level 4 in Management / Registered Managers Award and reported that she had enrolled on a National
Parkside Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 24 Vocational Qualification programme in Care at level 4. Training records for the Registered Manager were examined and these showed that the Manager had undertaken a range of Safe Working Practice and general training since the last visit, which was relevant to her role and responsibilities. Staff and residents spoken with confirmed that the manager was supportive and communicated a clear sense of direction. Comments received from two residents included; “It’s the best home ever” and “The manager is excellent”. Likewise, a member of staff reported; “Glenda is very approachable.” Some staff spoken with reported that they had not received regular formal supervision and records were not available for some staff. This was brought to the attention of the Registered Manager during the feedback. The home continued to commission an external quality assurance assessment and operated its own internal quality assurance system. This involved circulating questionnaires to residents and their relatives each year. Information on the outcome of the quality assurance process for December 2006 was available in the reception area of the home. Residents spoken with during the visit confirmed they had been asked to complete a survey and were confident that their views were listened to and acted upon. Previous inspection records detailed that the manager did not act as an appointee for any of the residents. The home’s accountant was responsible for the management of fees / invoices and a standing order system had been established for this purpose. Residents generally received assistance from family members or personal representatives to manage their personal finances. The home also provided safe storage for small amounts of residents’ monies. Staff spoken with demonstrated a good awareness of the home’s procedures for handling residents’ personal monies, including the need to record financial transactions and to obtain receipts for expenditure. The Annual Quality Assurance Assessment detailed that home had a Health and Safety at Work policy / procedure. Since the last visit, the home had arranged for a periodic inspection report for the electrical wiring installation. Records were not in place to confirm the emergency call system had been serviced. The owner reported that the home’s electrician was in the process of upgrading the nurse call installation and that a certificate would be obtained upon completion of the work. Pre-inspection records detailed that all other equipment within the home had been tested / serviced. Fire records were viewed during the visit. The records showed that the fire alarm system and automatic doors had been tested on a
Parkside Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 25 weekly basis. Furthermore, monthly inspections of the fire extinguisher, smoke detectors and emergency lighting had been undertaken. Records of regular staff training in fire drills had been recorded. Personal emergency evacuation plans had been developed for each resident and a fire risk assessment was in place. Good progress had been made in supporting staff to complete Safe Working Practice training. Some gaps were noted for night staff (please refer to Standard 30). Parkside Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 26 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 2 X 3 Parkside Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP29 Regulation 19 (1) (b) Schedule 2. Requirement Staff must not commence employment in the home until two satisfactory references have been received, to protect the welfare of the people using the service. Timescale for action 03/08/07 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 OP1 Good Practice Recommendations The home should review how information on the service is shared with prospective residents and their representatives, to ensure people have the necessary information to make an informed choice about where to live. Information on Equality and Diversity issues i.e. ethnicity and gender should be included in the assessment documentation, to improve assessment practice. ‘Service user care files’ should be condensed to minimise duplication of records and to ensure information can be accessed quickly and accurately. Staff should record regular observations of residents
DS0000046213.V337320.R01.S.doc Version 5.2 Page 28 2 3 4 OP3 OP7 OP7 Parkside Care Home 5 6 OP7 OP9 7 8 9 10 11 OP9 OP14 OP27 OP31 OP36 following falls, to ensure best practice. Residents or their representatives should sign care plans to confirm agreement with the content of the plan. The manager should undertake periodic competency assessments for all staff designated with responsibility for handling and administering medication, to ensure staff understand how to handle medication safely and correctly. Details of the medication to be self-administered should be recorded on the risk assessment for the resident who selfadministers medication Residents should be supported to open their own post at all times, so that they have control of personal correspondence. The Registered Manager should record the hours worked in the Care Home, to improve record keeping and accountability. The Registered Manager should complete an award equivalent to the NVQ level 4 in Management, to ensure she has the necessary qualifications for her role. All staff should receive formal supervision at least 6 times a year and records should be maintained. Parkside Care Home DS0000046213.V337320.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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