Inspection on 23/08/05 for Parkview

This inspection was carried out on 23rd August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Parkview 16/08/07

Parkview 29/08/06

Parkview 21/02/06

Parkview 21/02/05

Parkview 09/08/04

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

CARE HOMES FOR OLDER PEOPLE Russell House Woolwich Road Bexleyheath Kent DA7 4LP Lead Inspector Sue Meaker Announced Inspection 23rd. August 2005 9.30 am. The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Russell House Address Woolwich Road Bexleheath Kent DA7 4LP Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8303 7889 020 8304 8017 kcht@kcht.org.uk Kent Community Housing Trust Jane Kingsmill CRH 49 Category(ies) of DE(E) 49 registration, with number of places Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21st. February 2005 Brief Description of the Service: Russell House is a purpose built care home currently providing accommodation to 44 older people who are physically frail or have dementia care needs. The home is located in a residential area in Bexleyheath in the London Borough of Bexley; the home has good road, rail and bus links and access to shopping and leisure facilities in the local area. The home is operated by Kent Community Housing Trust. The home has undergone an extensive building and refurbishment programme over the last two years the final phase being due for completion in January 2006. The home will then be able to offer 69 en-suite bedrooms, arranged in units over two floors, 31 rooms on the ground floor and 38 on the first floor; the first floor is served by two passenger lifts. The bedrooms are to be in units, each unit having there own lounge and dining facilities. The completed first two phases of the building and refurbishment have been managed and completed to a high standard and works are continuing to upgrade the original part of the home to the same standard. The home has a day centre on site, which offers care on each weekday to elderley people with specialist dementia care needs. THe home has care parking to the front of the building and two attractive, well equipped, integral garden areas accessible to the residents and their visitors Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a statutory announced inspection carried out over eight hours, the inspection included a tour of the home. Four care plans and five personnel files were looked at in detail as were training records, health and safety records, accident and incident records, complaints records and medication records. Lunch was also observed. Six resident, five relatives and four members of staff were spoken to and a discussion held with the home manager and assistant manager. Five completed questionnaires were received from relatives all of which made positive comments about the home and the quality of care offered by the home. The home is nearing the completion of an extensive building and refurbishment programme that is due to be finished in January 2005. I would like to commend the home manager and staff team for the positive way in which this was managed with minimal disruption to the residents and the day to day operation of the home. I would also like to thank the relatives, residents, staff and management of the home for their input into this inspection. What the service does well: The home provides a good quality service to their residents; the staff have a good empathy with their residents and it was noted that the residents were relaxed, happy and comfortable in a homely environment, the atmosphere was calm in spite of the continuation of the building and refurbishment work still being carried out. Residents and relatives spoken to were appreciative of the improvements made to their environment particularly the new light, airy and spacious en-suite bedrooms and communal areas. The home has robust recruitment and selection processes in place and staff receive comprehensive training relating to the care of older people with dementia. Activities are an integral part of the services offered by the home and they have a competent activities co-ordinator who organises a range of activities and outings for the residents and it was nice to see relatives participating in these activities. During the lunch period, the food served was appetizing and well presented help was given to residents who required assistance this was done unobtrusively and sensitively. Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 6 What has improved since the last inspection? 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. Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,4 and 5 The home involves the resident and their relatives/representative in the assessment process enabling them to make an informed decision as to whether the home can meet their health, personal and social needs. Comprehensive information is provided within the Statement of Purpose and Service User Guide giving details of the services and facilities the home provides for residents. EVIDENCE: The home’s statement of Purpose is being continually reviewed and updated in line with the extensive building and refurbishment programme that is due for completion in January 2006. Residents, their families and staff are kept fully informed or progress with the project. The Commission will therefore require a reviewed and updated Statement of Purpose and Service User Guide on completion of the project. The London Borough of Bexley refer prospective residents to the home; an assessment is undertaken by the social services care management team; that is complemented by an assessment of health, personal and social needs by the managers in the home. Prospective residents are either visited in their own home or in hospital, by a representative of the home, where an Assessment of Needs for daily living is completed, this document along with the assessment Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 9 made by social services, will then form the basis of the residents individual care plan. Documentation seen in the care plans supported that this process was being followed and that residents, their relatives/representatives and healthcare professionals are also involved in the assessment and care planning process. Relatives spoken to at the time of the inspection felt that they were involved in the assessment and care planning process and that their views and concerns were taken into account. They also confirmed that their relative was able to visit the home prior to admission; and to spend the day getting to know the home, the staff and other residents. Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 and 9 Care plans ere personalised and individual to each resident promoting independence and choice respecting their right to dignity and privacy; enabling them to take minimised risks to achieve their chosen lifestyle. Residents are protected and kept safe by the homes’ policy and procedure and training relating to the safe administration of medication. EVIDENCE: Four care plans were looked at in detail; the current care plan documentation used is to be reviewed and updated by the organisation before December 2005. The care plan documentation inspected was comprehensive and gave clear and concise information on how to meet the health, personal and social needs of the resident. One of the care plans seen detailed the palliative care received by one of the residents in the home, the care plans and risk assessments are detailed and every effort is being made to make sure that the resident is comfortable and all health and personal needs are being meet, particularly around being nursed in bed, fluids and mouth care and personal care the care plan and corresponding risk assessments are being constantly reviewed and updated on a weekly basis so that continuity of care is maintained. Although care plan documentation is generic all the care plans and risk assessments are individualised to the resident. Of the four plans Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 11 inspected it was noted that they had been reviewed on a regular basis and updated as necessary. Annual reviews include all parties involved in the health, personal and social care of the resident and are arranged through social services care management and records are held on the service users main file. The residents are registered with the local GP who visits the home each week and on request; the GP was visiting the home during the inspection and made very positive comments about the relationship between the surgery and the home thus benefiting the residents. Primary health care services are accessed via the GP and the home is able to access podiatry, dental and optical services locally. The home has a comprehensive policy and procedure relating to the safe handling, administration and management of medication. Medication was checked on the ground floor unit, a monitored dosage system is in operation, documentation, computer generated MARS sheets, was checked and found to be accurately completed. All the MARS sheets had a photograph of the individual resident for identification purposes. Medication is administered by team leaders, assistant managers and the home manager, all of whom have received training in the Safe Administration of Medication. The home keeps a record of staff signatures of those who are responsible for the administration of medication. The medication room was light and airy and in a clean and hygienic condition, as was the medication trolley and the fridge, (temperatures were recorded daily), and all medication was stored in a locked facility therefore complying with regulations. Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15 Social activities are well organised, creative and provide stimulation and interest for people living in the home. Meals are nutritious and balanced and offer a healthy and varied diet for residents. EVIDENCE: The home employs an activities co-ordinator for 30 hours each week, who provides various exercise and creative activities as well as planning social functions and outings for the residents. During the inspection a quiz was being enjoyed by some of the residents along with some relatives. Residents and relatives spoken to said how much they enjoyed their activities and social events and that they looked forward to planning future events. The home provides an opportunity for residents to experience reflexology from a trained therapist and the services of a therapeutic masseur, at their own expense if they wish; the hairdresser visits the home on a regular basis. Visits to a local church of the residents’ choice can be arranged, and a monthly church service for all denominations is held in the home on a monthly basis. Lunch was served during the inspection and a tour of the kitchen was undertaken. Currently, because of the building work being carried out some of the dining rooms are small but this will change when the project is completed. The atmosphere in the dining areas was comfortable and the residents seemed relaxed, the meal was appetizingly presented and assistance offered in a Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 13 sensitive manner. Lunch comprised of a choice of Cottage Pie or Steamed Fish with parsley sauce, mashed potatoes, peas and carrots with strawberry mousse or banana custard for dessert; alternative choices were available. The menus seen looked balanced and nutritious with an emphasis on healthy eating. Drinks and snacks are available throughout the day and the residents and relatives spoken to during the lunchtime were very complimentary about the food served. The kitchen had obtained a Silver Clean Food Award from Environmental Health in July 2004, the kitchen was light and airy and well-equipped, everying was in a clean and hygienic condition; a daily, weekly and monthly cleaning schedule was being adhered to and all food, fridge, freezer and hot trolley temperature was being kept accurately. Risk assessments were being done and the kitchen staff was aware of the need for hazard analysis; all kitchen staff have received training relating to food hygiene. Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The home has comprehensive systems in place in the home therefore ensuring that the residents feel safe and protected within their environment. EVIDENCE: The home has a robust policy and procedure relating to complaints, these documents are detailed in the homes’ Statement of Purpose, in the Service User Guide and displayed around the home. From inspecting the complaint records it was clear that complaints were dealt with in line with the organisations policy and procedure. All complaints were addressed within the proscribed timescale and the resolution of the complaint communicated to the complainant; five complaints have been investigated since April 2004, all were substantiated and resolved to the satisfaction of the complainant. None of the complaints required an investigation under the Protection of Vulnerable Adults procedure and none were referred to the Commission. The comment cards received by the Commission from relatives confirmed that the complaints policy and procedure was readily available and of the relatives spoken to on the day of the inspection, stated that any issues or concerns they had were dealt with by the manager of the home promptly and with sensitivity. The home adheres to a stringent policy and procedure relating to the Protection of Vulnerable Adults, this policy and procedure is implemented in conjunction with the guidelines set by the London Borough of Bexley. Management and staff have attended training courses around this issue and are able to recognise and act upon any allegation of abuse. Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,24,25 and 26. The building and refurbishment programme in this home is aimed at improving the surroundings and facilities for the residents to enjoy and maintain a comfortable lifestyle, it was evident that this goal is being achieved to a high standard. EVIDENCE: This home has been undergoing an extensive building and refurbishment programme that is now nearing completion, the programme is on schedule to be finished in January 2006. The programme has been managed so as not to impinge on the safety of the residents and staff, comprehensive risk assessments have been put in place and the residents and relatives spoken to agreed that the home has been much improved as to the facilities that are now available, the bedrooms are now en-suite, well decorated and furnished to a high standard; residents and their relatives have been involved at every stage of the building and refurbishment process and have been able to choose their new rooms and have some input into the decoration. It was evident from the bedrooms viewed that residents and their relatives had been able to Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 16 personalise the bedrooms with small items of furniture, photographs, pictures and ornaments; residents also had televisions and radios in their rooms. The older part of the building is in the process of refurbishment and this area will incorporate a further en-suite bedrooms; once all the works are completed the home will be inspected by the central registration team before the capacity of the home is increases; issues have been raised by the registration team relating to the length of the corridors and the number of corners and turns, this raises questions relating to the staff being able to monitor the residents effectively particularly at night; in light of these issues staffing levels will need to be appropriate for the effective care of the more vulnerable residents in the home. Steps need to be taken to ensure the health and safety of the residents during the day and particularly at night; the Commission would need to be assured that measures are put in place to address these issues. The home was clean and tidy and there were no unpleasant odours; the home creates a homely atmosphere and a spacious and comfortable environment for the residents and their visitors The communal areas are light, spacious and well decorated and furnished and two new courtyard areas have been created for the residents and relatives use. Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 and 30 The homes’ recruitment policy and procedure, and training programme ensures that the staff are able to effectively meet the personal, health and social needs of the residents. EVIDENCE: The staff rota seen showed that the home is maintaining staffing levels previously set by the local authority, these levels need to be closely monitored to ensure that the home maintains adequate staffing to meet the assessed health, personal and social needs of the residents. It will be necessary for the organisation to review staffing levels once the homes’ building and refurbishment programme is complete and the number of beds increased from forty four to sixty nine. The home has comprehensive recruitment and selection procedures that are compliant with the National Minimum Standards – Care Homes Regulations; personnel files inspected were found to comply with Schedule 2. The organisation has a comprehensive induction programme for new staff that comprises an induction handbook- work- book, once this is satisfactorily complete staff are required to undertake a foundation in care course prior to being offered an NVQ qualification course. All statutory training is undertaken and updated as required by the standards including moving and handling, first aid, food hygiene and health and safety. As the home is for older people diagnosed with dementia the home provides comprehensive training in dementia care, managing violence and aggression and managing challenging and disruptive behaviour. Currently fourteen members of staff have achieved NVQ qualifications and a number of staff are being put forward to commence Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 18 the course; this means that the home has already achieved the target of 50 of care staff being NVQ qualified before the end of 2005. The home has an annual training programme, staff spoken to during the inspection confirmed that the training offered is comprehensive and that they are encouraged to undertake courses to enhance their skills and experience; five personnel files were inspected and found to contain certificated, successfully completed training courses. Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33 and 38 The home benefits from efficient and effective management enabling the residents to fell safe and protected in their home environment and the staff also benefit from the clear direction and leadership of the management team within the home. EVIDENCE: The home has an experienced registered manager who has been in post for the last three years; she has successfully completed the Certificate in Management (NVQ4) and the Registered Managers Award. Residents and relatives spoken to stated that they appreciated the openness and transparency of the management approach in the home; particularly around information given relating to the building and refurbishment of the home, the fact that they were kept informed of developments and timescales of works being carried out; this led to a good understanding between residents, relatives, management and staff of any concerns that may be experienced and how these concerns could be managed and overcome. It was evident from speaking to the home Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 20 manager that every effort was made to ensure that the building and refurbishment caused minimal disruption to the day to day running of the home and that the residents continuity of care was maintained throughout the programme. The home manager and staff team are to be commended on the way in which the building and refurbishment programme has been and still is being managed. The home carries out an annual survey of residents and relatives and the results of which are published. Individual surveys are undertaken relating to quality of care, domestic services and catering services, these surveys are on a three monthly basis. A survey of residents and relatives was undertaken in June 2005 relating to the improvements made to the homes’ environment, the result of which was very positive. Health and Safety records were checked in accordance with information given in the pre-inspection questionnaire and found to comply with National Minimum Standards – Care Homes Regulations. Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 2 x x x 3 3 3 STAFFING Standard No Score 27 x 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x x x 3 Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 22 No 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 Regulation Requirement Timescale for action 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 1 Good Practice Recommendations The Commission to be sent a copy of the reviewed and updated Statement of Purpose and Service User Guide when the building and refurbishment works have been completed. The Commission to be advised of the measures put in place to monitor the health and safety of the residents once the building works are completed; this reccommendation relates to adequate staffing during the day and at night. 2. 19 Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 23 Commission for Social Care Inspection Riverhouse 1 Maidstone Road Sidcup Kent DA7 4LP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Russell House G51G01s6794RussellHse.v234626.23.8.2005stage4.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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