Inspection on 13/07/06 for Parkview House

This inspection was carried out on 13th July 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Parkview House 19/07/07

Parkview House 10/01/07

Parkview House 09/02/06

Parkview House 23/10/05

Parkview House 08/02/05

Parkview House 23/07/04

Parkview House 24/02/04

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

CARE HOMES FOR OLDER PEOPLE Parkview House 12 Houndsfield Road London N9 7RQ Lead Inspector Tom McKervey Key Unannounced Inspection 09:30 13 & 14th July 2006 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 Parkview House DS0000010566.V303693.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. Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parkview House Address 12 Houndsfield Road London N9 7RQ 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) 020 8805 7031 020 8805 4371 2 Care Vacant Care Home 45 Category(ies) of Dementia - over 65 years of age (45) registration, with number of places Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th February 2006 Brief Description of the Service: Parkview House is operated by 2 Care who operate other care homes nationally. The building is leased from Sanctuary Housing Association, which is responsible for maintenance and repairs. This home is registered to care for forty-five older people who have a diagnosis of dementia. The home is purpose built and opened in 1993. Residents live in five units, called clusters, which each house nine people. The units are self-contained to provide a more homely environment, each with its own lounge, dining room and small kitchen for preparing drinks and snacks. There is a central laundry and the central kitchen caters for the main meals, Although the living accommodation is in separate units, the residents are able to move around the whole building, and do so quite safely, as the entrance and exit to the home is protected by a coded keypad and CCTV. The home is a two-storey building with a car park at the front of the premises. There are three internal garden areas with attractive water features and there is a long ramp and a passenger lift, to provide access to the first floor. In addition, there are spacious communal areas and a “Snoezelen” room for providing sensory stimulation and/or relaxation for the residents. The home aims to provide a high level of support to residents to maintain their independence and quality of life. The home is located in Edmonton, opposite a public park. The fees for the service are £508 per week. Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of two days. The inspection was carried out as part of the Commission’s inspection programme and to check compliance with the key standards. At the time of the inspection, there were no vacancies. The new manager was present throughout the inspection and fully cooperated in the process. The inspection consisted of a tour of the premises, including speaking to residents, relatives and staff. Three relatives, and two friends of residents who were visiting during the inspection, were also spoken to about their views of the service. A discussion also took place with several staff, individually and as a group. These interviews were conducted independently of the manager. As part of the inspection process, residents’ and staffs’ records and other documents relating to the efficient running of the home were examined. What the service does well: What has improved since the last inspection? A new manager has been appointed who has previous relevant experience of managing a care home. Professional advice was sought and a resident’s family was consulted about their language difficulties. Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 6 Many staff have attended training in adult protection procedures and agency staff have been trained in mandatory subjects regarding health and safety. Formal supervision has also started for agency staff. All fire extinguishers are securely fixed to the wall and regular fire drills are now being held. There are better security systems in place, including protected entry to the home and the fitting of restrictors on the downstairs windows. What they could do better: A number of requirements made at the last inspection have not yet been met and have been restated in this report, with a new timescale for compliance. In the “Timescale for Action” column, the date in ordinary type relates to the timescale given at the last inspection. The date in bold type relates to the new timescale. Further information about unmet requirements can be found in the relevant standard. Unmet requirements can impact upon the welfare and safety of residents. Failure to comply by the revised timescale may lead to the Commission for Social Care Inspection considering action to secure compliance. All residents must have a care plan to guide staff on how best to meet residents’ needs. It is also important to invite service users’ representatives to be involved in reviewing the care plans. All care staff need to be aware about the meaning of “risk management” to ensure that residents’ welfare is safeguarded. All medication that is administered must be signed for so that mistakes are avoided. Staffing levels need to be increased so that when two staff are attending to a resident, the other residents are not left unsupervised. Care staff should be freed from cleaning and laundry duties to allow them to devote more time to residents’ individual needs. The range of activities for residents must be extended, particularly one-to-one, so that residents are appropriately stimulated. This could be considerably improved by raising the number of staff available, and by the appointment of an activities coordinator. Staff need to ensure that they support residents who need help with eating in a manner that ensures their dignity is preserved and the meal is hot when they eat it. Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 7 Senior managers from 2Care need to undertake improvements to address the many environmental issues identified in this report, which include improving cleanliness, replacing furniture and improving the décor in the “clusters”. All staff must have training in infection control for their own protection and that of the residents, and where appropriate, checks must be carried out to ensure that staff have Home Office approval to work. When residents undergo health checks or attend appointments, the outcome should be documented in their records. It is important to ensure that fire doors are not wedged open, so that in the event of a fire, the risk of it spreading is reduced. 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. Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5. Standard 6 does not apply. The quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. There is very good up to date written information about the service. However, this information is not always given to new service users and/or their representatives at the time of admission. Licence agreements are in place for residents whose care is funded by the local authority, and contracts are issued to residents who are self-funding when they become permanent. All residents have a comprehensive assessment of their needs prior to admission to the home, and they and their relatives can visit the home to assess its suitability to meet their needs. EVIDENCE: Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 10 There is a “Guide to living at Parkview House” document that gives comprehensive information about the service and residents’ right are detailed in the “Service Users’ Charter”. One resident’s relatives who were spoken to during the inspection, stated that they had not been given a copy of this information. A requirement is made to provide this. The majority of residents in the home are funded by the local authority on a block-contract basis. Licence agreements were seen for these residents, which detailed their rights and the responsibilities of Sanctuary Housing who are the landlords. One resident, who is self-funding, did not have a contract in their file. The manager stated that this resident was still in the trial period, and if they become a permanent resident, a contract would be issued at that stage Five case files were sampled. They confirmed that service users were fully assessed by care managers and senior staff in the home before admission. The assessments included risk assessments of mobility, falls and risk of pressure ulcers. An assessment of daily living skills was also recorded to support care planning. At the last inspection, a requirement was made for the linguistic needs of a Greek resident to be assessed. Their records showed that they were reassessed by the psychiatrist and the relatives were satisfied that the resident’s communication needs were being met as far as possible by the staff. The home is purpose-built to provide care for older people with dementia. Relatives who were spoken to, said they liked the design of the building that, while providing a homely atmosphere in each unit, allows residents to move around all areas of the home safely and without restraint. A smoking room is available for use by residents, staff and visitors. Before a resident moves in, a checklist is completed, which includes a status report of the condition of the bedroom. All internal areas of the home are accessible for residents, including those with mobility problems. Relatives told the inspector that they had visited the home to assess its suitability prior to admission. They also said that the staff always informed them about accidents or any concerns about their relative. Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 10 & 11 The quality in this outcome group is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Not all residents have a written care plan, and some relatives have not been invited to participate in their resident’s care planning. Some staff does not understand the concept of “risk management”. This could compromise the welfare of residents. Residents and their representatives say they are satisfied with the care provided and say they are treated with dignity and respect. The healthcare needs of residents are being met, but this could be better documented. Medication is safely stored, but more attention is needed in the recording of the administration of medicines to safeguard service users. The wishes of residents in the event of their death are documented. EVIDENCE: Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 12 The records of five residents were examined. One resident from Pymms unit did not have a written care plan or risk assessment, neither was this person’s G.P recorded. A requirement is made for these to be provided. The remaining four care plans were of a good standard and provided guidance for staff about how to meet residents’ needs. Some of the care plans were signed by service users’ relatives, which demonstrated their involvement in, and agreement with the care plan. The care plans were reviewed on a monthly basis. The next of kin of a resident in Grovelands unit said that they would like to attend their relative’s care plan reviews but had never been invited. A requirement is made for service users’ representatives to be invited to care planning reviews. Annual care reviews by social workers, to which relatives were usually invited, were documented. There was evidence that there is a full range of health professionals involved in supporting the residents. These include the psychiatrist and local G.P who visit the home regularly and review residents’ health needs. Appointments for dentists, opticians and chiropodists were documented and residents were supported to attend hospital outpatient departments. At the time of the inspection, one resident had a pressure ulcer. This was appropriately documented in their records. There were risk assessments about developing pressure ulcers, and where identified, pressure relieving mattresses and cushions were used. A relative requested that protective rails be used at night to prevent a resident from falling out of bed. The manager agreed to this in the presence of the inspector, subject to a risk assessment and consent from the relative being documented. A resident in Pymms unit has Parkinsons disease, which very often causes severe difficulty in their movement and an inability to feed themselves. The inspector was concerned that the risks associated with this condition were not addressed in a risk assessment, particularly the risk of falling and of choking when eating. The inspector was also concerned that a member of staff in this unit did not appear to understand the concept of risk management in relation to residents’ welfare. A requirement is made to address these issues. Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 13 Medication was stored in cupboards in some units and in dressers in others, all of which were kept locked. Generally, medication was safely administered, but some discrepancies in the administration of medicines records were noted where medication had not been signed for. A requirement is made to address this. The majority of service users have advanced dementia, but two residents who were spoken to, said that the staff were very kind and caring and treated them with respect. Relatives were complimentary about the staff. One said, “The care is marvellous, I cant speak highly enough of the staff, they are so patient”. A letter from relatives of a resident who had died at the home stated, “Best practice is a phrase commonly used, and this standard was followed by all his carers. We are at peace knowing that we made the right decision in leaving dad at Park View where he ended his life in peace”. The wishes of residents and their representatives about funeral arrangements were recorded in the case files. Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 The quality in this outcome group is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The structure of the home enables residents to access all internal areas of the home safely and their cultural and religious needs are respected. There is an open visiting policy, and residents who are able to express preferences, are supported by staff to exercise choice. There needs to be a wider range of group and one to one activities, including taking residents outside the home to give more stimulation. More care must be taken at mealtimes to ensure that residents who are unable to feed themselves are supported properly in an unhurried and respectful manner. EVIDENCE: The sample of care plans showed that assessments of residents’ religious and cultural needs and their likes and dislikes were carried out. An assessment of daily living skills was also recorded. Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 15 Two residents who were able to converse, said that their wishes were respected in relation to joining in activities, rising and going to bed. They could also choose alternatives to the menu. Many residents were observed outside their own units, walking around all internal areas of the home and gardens. This is possible because of the unrestricted access. There is a large communal room that is used for group activities. The practice in the home is for each unit or cluster to be responsible for organising an activity, which takes place at three pm each day, and the other units are invited to attend. The activities include art and craft, reminiscence sessions and musical entertainment. Residents’ birthdays are celebrated throughout the home and “theme nights” are held to reflect different cultures, for example; Greek and Polish. There is a sensory garden containing perfumed shrubs and plants and a vegetable garden, which some residents help to tend at the weekends. The home also has a “Snoezelen” room for providing sensory stimulation or relaxation for the residents. However, the inspector was informed that this is only used on a Friday afternoon, which would appear to an underused facility. There did not appear to be much planned individual activity or evidence of residents being taken outside the home, apart from one resident who attends a nearby day centre run by Age Concern. The inspector noted a singsong session taking place in one unit on the second day of the inspection, but generally, there was little social interaction taking place between staff and residents. Several staff said that more activities should be provided, but that this was difficult with only two staff on each unit, and the lack of an activities coordinator. In addition to care duties, the care staff are required to do the cleaning in the individual units and put away the laundry. A recommendation is made to recruit an activities coordinator and to extend the range of group and individual activities for residents. The visitors’ book recorded frequent visits by relatives and friends, and those spoken to during the inspection, said that they were always welcomed at any time by the staff. Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 16 The menus indicated that well-balanced and nutritious meals were provided. Two residents said there was plenty to eat and they could choose alternatives to the planned menu. The inspector was concerned about two issues relating to residents’ mealtimes. One concerned seeing a meal left at lunchtime beside a resident who could obviously not feed themselves and by the time the staff had attended to them, the meal had gone cold. In another instance, a member of staff was supporting a resident to eat. This was being done in a hurried manner and while standing over the resident, rather than sitting beside the resident and taking sufficient time. A requirement is made about these issues. Parkview House DS0000010566.V303693.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The quality in this outcome group is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Residents’ welfare is safeguarded by staff awareness of, and being trained in, adult protection procedures. While those complaints that are recorded are dealt with appropriately, not all complaints are logged, which could undermine residents’ and relatives’ confidence in the complaints procedure. EVIDENCE: There is an appropriate complaints procedure in place, which gives reasonable times for responding. The complaints log was examined. Those complaints that were recorded, were dealt with appropriately. However, during the inspection, a relative told the inspector that they had complained about the poor state of their mother’s room, and this complaint was not logged. A requirement is made for all complaints to be recorded. Since the last inspection, a training programme for staff in adult protection procedures had taken place and in discussion with the inspector, staff were able to describe their responsibilities regarding “whistle-blowing”. Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 18 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, 24 & 26 The quality in this outcome group is poor. This judgement has been made from evidence gathered both during and before the visit to this service. The standard of decoration and the condition of much of the furniture in the units is poor and there are offensive odours in many areas of the home. This does not provide a suitable environment for residents to live in. EVIDENCE: The building is owned and maintained by Sanctuary Housing Association. A tour of the exterior and interior of the home was carried out. This included all the communal areas and several residents’ bedrooms. The home adjoins a housing estate and there is a large, attractive public park directly opposite the home. The home also has its own car park. Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 19 A keypad entry and exit system and CCT provides good security for the home, and the manager stated that the local crime prevention officer had recently visited the home to offer further advice. The gardens include a sensory garden with lavender, lights and water features. There is a raised bed vegetable plot, which enables residents to get involved in the gardening. The layout of the home allows residents to access all internal areas of the home and to walk about unaccompanied, safely and freely. Each unit has a notice board providing information about the planned activities and the menus. The central kitchen is spacious and well equipped and the laundry has appropriate washing and drying machines. The laundry storage areas were rather small, and at the time of the inspection, which was on a very hot day, were uncomfortable for the staff to work in. The staff had wedged open three fire doors to provide relief from the hot conditions. A requirement is made under Standard 38, (health and safety), for appropriate devices to be fitted to these doors so that they will close automatically when the fire alarm is raised. There is a designated smoking room and several communal areas for residents and visitors to sit, and both floors can be accessed by a long ramp and a passenger lift. All the windows have had restrictors fitted for the safety of the residents. The décor in the communal areas of the home was of a reasonable standard. New dining furniture had been purchased for some of the units since the last inspection. At the time of this inspection, new garden furniture had also just arrived for the balconies. However, the following deficits were identified There was an unpleasant odour at the entrance to some of the units and in some bedrooms as identified below. The small balconies of two upstairs units were very untidy with dead leaves and some litter lying about. There was graffiti on the wall facing the road. Durrants Cluster. The lounge and skirting board in the dining room need redecorating. The wooden window frame in the corridor was splintered and could injure someone. Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 20 Jubilee Cluster. The wiring for some bed buzzer alarms had come away from the wall. The Formica dining table was dirty and sticky and should be replaced as it is out of keeping with the rest of the furniture. The kitchen is in need of repainting. There was an offensive odour in Room 5, which a resident’s relatives had complained about. (The inspector was informed that a contractor was due imminently to measure the room for a new carpet.) Grovelands Cluster. There was an odour of urine in Room 7. The carpet and bed were badly stained and should be replaced The dining furniture was worn and the frames of some chairs were loose and could collapse. The ceiling was stained and needed to be repainted, and the carpet in Room 8 was very stained and should be replaced. Montague Cluster. The dining room needs redecoration and the furniture does not match. There was an offensive odour in the sluice room, the door of which was stuck. Requirements have been made to address these issues. Other bedrooms visited were of an acceptable standard with evidence of comfortable furniture and personal possessions. Two residents who were spoken to, said they liked their accommodation and they could see their relatives in their rooms if they wished. Parkview House DS0000010566.V303693.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 The quality in this outcome group is poor. This judgement has been made from evidence gathered both during and before the visit to this service. There is an insufficient level and consistency of care staff available, creating a risk that residents’ needs are not being fully met. There are generally thorough recruitment procedures in place to protect service users from potential abuse, but appropriate documentation about staffs’ right to work is not always obtained. There is a programme of training for staff in health and safety, and they have a good understanding of caring for people with dementia. However, a previous requirement for staff to be trained in the control of infection has not been met. EVIDENCE: The staff rotas were examined. They showed that there are normally two care staff on duty during the day and one at night to care for nine service users on each unit. The two staff on the rota often includes a senior carer who has additional management responsibilities for the unit. At the time of the inspection, there were six care staff and three senior carer vacancies. The shortfall was being met by agency staff, which does not enable continuity of care. However, the manager stated that a major campaign, in Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 22 partnership with a recruitment agency, was planned to take place soon and she was confident of a good result. 2.5 whole time equivalent, (w.t.e.) staff are responsible for cleaning the communal areas of the home. 1 w.t.e. staff does the laundry and there are four hours provided for gardening and twenty hours for maintenance. Staff said that many residents on each unit required personal support from two carers. The inspector was concerned that while staff were engaged in this task, the remaining residents were not being supervised. Care staff are also required to clean the units and put away residents’ laundry. The staff said that all these duties make it difficult for them to provide one-toone activities, for example, to take residents on walks etc outside the home. At the last inspection, a requirement was made to address concerns about staffing levels. This requirement is restated. All staff receive an informative handbook and have a written induction to the home when they start working. Training in mandatory subjects, for example health and safety, is also provided. Staff were trained in caring for people with dementia, and observation and discussion with staff confirmed their knowledge about this subject. At the last inspection, a requirement was made for all staff to be trained in infection control. The manager stated that she was trying to arrange this as soon as possible. In the meantime, this requirement is restated. There was evidence that staff were supported to undertake training in National Vocational Qualifications. The records of staff who started since the last inspection were examined. The staff files were well structured, indexed and they contained application forms and interview notes. There were documents confirming proof of identity and records of training. Appropriate references were obtained and Criminal Records Bureau, (CRB) or Protection of Vulnerable Adults checks had been obtained. In relation to one person, it was not clear if they had permission from the Home Office to work and a requirement is made for the manager to seek clarification about this matter. Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 23 Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 24 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): 31, 32, 33, 34, 35, 36, 37 & 38 The quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. There is an experienced and appropriately qualified manager in charge of the home and clear leadership is provided for staff. Staff and relatives are involved in the running of the home, and staff are supported in their roles through regular supervision. There are good systems in place for managing residents’ personal finances and there is a business plan for the cost of the service. Residents’ healthcare records need to be better documented. Residents’ and staffs’ welfare is safeguarded by regular servicing of equipment and monitoring of health and safety. EVIDENCE: Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 25 At the time of the inspection, the manager had been working at the home for two months in an interim capacity, but had only just been confirmed in post. She is a registered learning disabilities nurse and had previous management experience. The manager is an accredited trainer with the British Institute for Learning Disabilities and is currently applying for registration with the Commission for Social Care Inspection. The manager demonstrated a commitment to complying with the requirements from the inspection and improving and maintaining the standards of care in the home. She is supported by a deputy, administrator and senior carers. One senior acts as duty manager on a rostered basis. A senior manager from 2Care, makes monthly inspection visits to the home and sends the reports to the Commission for Social Care Inspection. The manager holds regular meetings with staff and relatives to keep them informed and involve them in the running of the home. Staff said their morale had improved with the appointment of the new manager. Her style was described as being hands-on, approachable, and supportive. At the time of the inspection, there was a friendly and relaxed atmosphere in the home. Staff said that they received regular supervision, which they described as very useful in supporting them in their work. The inspector sampled records of the personal money held on behalf of residents, which was kept in individually named envelopes. The money balanced with the amounts recorded in the ledger. The inspector saw the five-year budget and business plan for the home, which identified the projected costs of running the home. However, as identified under the environmental standards, this should be reviewed and the timescales for much of the planned improvements brought forward. Residents’ records were generally of a good standard. However, the healthcare records were not always complete. For example, the results of blood tests were not recorded and reviews by the psychiatrist and G.P were not always documented. A requirement is made about this issue. Current certificates of safety were seen for fire, gas and electrical installations, and an employer’s liability insurance certificate was on display. The water supply had also been tested. Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 26 There were records of servicing of the lift and mechanical hoists, and fire alarms were tested weekly and drills carried out. A fire risk assessment of the home had been completed. A requirement is made about propping open fire doors; (see comment under Environment Standards) Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 1 X X X X 2 X 2 STAFFING Standard No Score 27 1 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 2 2 Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard OP7 OP7 Regulation 14 (1,2) 14 (1,2) Timescale for action The registered person must 31/08/06 ensure that a care plan is available for all residents. The registered person must 30/09/06 ensure the concept of risk assessment and management is understood by all care staff. The registered person must 31/08/06 ensure that all administered medicines are signed for accurately. The registered person must 30/09/06 ensure that more stimulating activities are provided for the residents, particularly on an individual basis. The registered person must 30/09/06 ensure that staff who are supporting residents to eat, do so in a manner and at a pace that respects the resident’s dignity and their meals are not left to go cold. The registered person must 30/09/06 ensure that all concerns and complaints by residents or their representatives are recorded. The registered person must 31/12/06 ensure that the following issues DS0000010566.V303693.R01.S.doc Version 5.2 Page 29 Requirement 3. OP9 13(2) 4. OP12 16(2)(n) 5. OP15 16(2)(i) 6. OP16 17(2) Sch 4 23(2)(d) 7. OP19 Parkview House are addressed. Durrants Cluster. The lounge and skirting board in the dining room are redecorated and the wooden window frame in the corridor is repaired or replaced. Jubilee Cluster. The wiring for alarms is firmly The Formica replaced and redecorated. the bed buzzer fixed to the wall. dining table is the kitchen is Grovelands Cluster. The carpet and bed in Room 7 are replaced. New dining furniture is provided. The ceiling is repainted. The carpet in Room 8 is thoroughly cleaned or replaced. Montague Cluster. The dining room is redecorated and matching furniture is provided. The door of the sluice room can be closed, and steps are taken to ensure that there are no offensive odours in that room. The registered person must 30/09/06 investigate and address the cause of offensive odours throughout the home. The registered person must 30/09/06 ensure that rubbish is removed from the upstairs balconies and the graffiti is removed. DS0000010566.V303693.R01.S.doc Version 5.2 Page 30 8. OP26 16(2)(k) 9. OP26 16(2)( Parkview House 10. OP27 18(1) a 11. OP29 17 (2), Sch. 4 The registered persons must 31/10/06 ensure that staffing levels are sufficient enough at all times to ensure that; • Residents are not left unsupervised when other residents are receiving personal support. Residents have one-to-one activities and are able to be taken outside the home when they wish. The registered persons must 30/10/06 ensure that, where appropriate, copies of evidence of staff member’s right to work are obtained and kept on file. This requirement is restated. The previous timescale was 30/04/06. The registered persons must 31/10/06 ensure that all staff are trained in infection control. This requirement is restated. The previous timescale was 30/05/06. The registered person must 30/09/06 ensure that the results of blood tests and doctors’ appointments are documented in the residents’ healthcare records. The registered persons must 31/08/06 ensure that fire doors are not propped open. This requirement is restated. The previous timescale was 30/04/06. 12. OP30 18(1) 13. OP37 17(1)(a) 14. OP38 12 (1) 13(4) Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 31 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. 2. Refer to Standard OP12 OP12 Good Practice Recommendations The registered person should employing cleaners for the clusters. The registered person should recruit an activities coordinator for the home to extend the range of group and individual activities for residents. Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Parkview House DS0000010566.V303693.R01.S.doc Version 5.2 Page 33 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!