Inspection on 24/07/07 for Parkview House

This inspection was carried out on 24th July 2007.

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

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

Other inspections for this house

Parkview House 22/11/06

Parkview House 14/01/06

Parkview House 14/07/05

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Parkview House 208-212 Chingford Mount Road Chingford London E4 8JR Lead Inspector Harbinder Ghir Key Unannounced Inspection 24th July 2007 09:05 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 DS0000061980.V346889.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 DS0000061980.V346889.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parkview House Address 208-212 Chingford Mount Road Chingford London E4 8JR 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 8524 9234 020 8559 3115 Parkviewhouse@tesco.net Carebase (Parkview) Ltd Ms Ann Marie Crane Care Home 53 Category(ies) of Dementia - over 65 years of age (9), Old age, registration, with number not falling within any other category (0) of places Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. To Include one (1) named service user aged 64 years. The home can provide care for a named service user with dementia need. 22nd November 2006 Date of last inspection Brief Description of the Service: Care Base (Park View) Ltd. is part of Care Base Ltd. registered to accommodate 53 elderly people. The home is situated in South Chingford, in the London Borough of Waltham Forest. Care is offered in four units, each comprising a combined lounge/dining area plus near-by bedrooms designated for each unit. In addition, there is a quiet room to entertain guests. Most of the bedrooms are single but four are doubles, each shared by two people. All bedrooms have en-suite facilities of wash hand basin and lavatory with some also having a step-in shower. There are separate offices for the manager and administrator and a hairdressing room. Meals are prepared and cooked in the central kitchen by catering staff, then passed through a hatch to one unit and transported in heated trolleys to the other three units. Each unit has a small kitchen area for serving meals or preparing drinks and snacks. There are central laundry facilities. The home is on a main road has a good parking area and is near to public transport and shops. There are several attractive courtyard gardens accessible to service users that are well used in the good summer weather. At the time of this inspection, the home is currently charging a weekly fee up to £750 per head for the care services. Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken by Regulation Inspector Harbinder Ghir. The inspection took place on the 24th July 2007 between 9.05am and 4.30pm. The registered and deputy managers of the home were available throughout the time to aid the inspection process. During the inspection the inspector was able to talk to the service users residing at the home, staff and relatives who were visiting during the inspection, relatives were also contacted by phone. The District Nurse was also spoken to. The London Borough of Waltham Forest Commissioning Unit who are the host authority for the service, and the London Borough of Tower Hamlets was contacted by telephone who fund people who use this service, inviting their comments on the service that they are commissioning, but no comments were returned. As part of the inspection the inspector toured the home, read records of people who use the service and examined documents in relation to the management of the home. At the end of the inspection the inspector was able to provide feedback to the manager. The inspector would like to thank everyone involved in the inspection process. What the service does well: As part of the inspection the District Nurse was visiting the home and was spoken to. She commented positively on her involvement with the home and expressed no concerns about the care being provided; and that any instructions given was well received and actioned accordingly. Visiting times are flexible and people are made to feel welcome in the home so that residents are able to maintain contact with their family and friends. The service completes comprehensive pre-admission assessments, to ensure they can meet the needs of residents. The service achieves good outcomes for meeting the needs of those residents with a diagnosis of dementia. Trial visits are offered to all prospective residents, to ensure residents have information on the services and facilities provided at the home. Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 Page 6 All residents can be assured, that at the time of their death, staff would treat them and their family with care, sensitivity and respect. The home has an equal opportunities policy to ensure residents or staff members are not discriminated against on the grounds of race, culture, age, sexuality or gender. The service has robust recruitment procedures ensuring the safety of residents. The service has a permanent staff team and does not use agency staff, which ensures a consistent service being provided to residents. Staff qualifications evidenced that the service has a ratio above 50 of NVQ qualified staff. 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. The summary of this inspection report can be made available in other formats on request. Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4, 5, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose and the Service User Guide provide adequate information to enable residents and prospective residents to make an informed choice on whether they would like to live at the home. However, the documents need to be updated to ensure they are in line with the Care Homes Regulations 2001. The service completes comprehensive pre-admission assessments, to ensure they can meet the needs of residents. Trial visits are offered to all prospective residents, to ensure residents have information on the services and facilities provided at the home. The service does not provide intermediate care. EVIDENCE: Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 Page 9 The Statement of Purpose provides information, which is specific to the individual home, and the resident group they care for. However, the document does not provide all the information required by the Care Homes Regulations 2001, and it is Requirement 1 that the document is updated in accordance with the regulations. The service is supported by a Service User Guide, which details what the prospective individual can expect and gives a clear account of the aims and objectives of the home and its philosophy of care. Both documents were presented in text format, which were not suitable to the communication needs of people who use the service, as the service provides care for a service user group, who have varied levels of communication. It is Recommendation 1 the service considers providing the documents in formats, such as Braille, appropriate languages, pictures, video and audio. Three pre-admission assessments were closely examined, two of which were for newly admitted residents. Records showed that comprehensive preadmission assessments are completed before a prospective resident is admitted to the home. All records inspected included a care needs assessment of the resident, covering their physical, mental and emotional health care needs. A mental status and dependency level assessments were also completed as part of the pre-admission process, which were of great benefit for those individuals with a diagnosis of dementia. For Local Authority funded residents, the service had obtained care management assessments from the placing authority and the above pre-admission processes were also followed for any residents admitted for a respite stay at the home. Trial visits are offered to all prospective residents and their relatives and representatives are also invited to visit the home. One resident spoken to stated, “I couldn’t visit the home, but my wife came to have a look round a number of times.” Another resident spoken to stated “My nephews came to have a look at the home for me, and said it was the home for me.” Residents are admitted on a 6-week trial basis to ensure they make the right decision on whether they would like to live at the home. The home has also introduced a new scheme where they invite all prospective residents for lunch, to enable them to test the meals, meet staff and other residents. All the residents spoken to, spoke very positively regarding the care they received at the home. Comments included “I’ve been at the home for two years, and I couldn’t have done any better. Everybody here is very considerate, and the carers are very good to me.” Another resident stated, “The staff are very good, some of them are darlings and we get what we ask for.” Further comments included “Its ok here, they are all ok.” “I can’t complain, I am happy here, I have never had any problems, the carers are very good.” Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health and personal care needs are set out in individual care plans. Care plans are detailed, but need to ensure all the information in the documents is consistent and is correct to ensure the needs of residents can be met effectively. There are clear medication policies and procedures to follow. However, there are some inconsistencies in the management of medication, which may result in unsafe practices. All residents can be assured, that at the time of their death, staff would treat them and their family with care, sensitivity and respect. EVIDENCE: Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 Page 11 Six care plans were closely examined and case tracked. The service has introduced a new care plan format, which is comprehensive, and clearly sets out residents’ health, personal and social care needs. Information was found specific to the religious, cultural and social care needs of residents and how the service was to meet these. For one resident, who was Jewish, the care plan clearly recorded that the individual was not a practising Jew and had specified that they would like to eat bacon and ham, which the home provided. However, concerns were identified in the inconsistency of information provided on one care plan. For one resident the care plan identified that the individual was at risk of falling out of bed and cot sides had been put in place. However, on viewing the manual handling assessment, under physical risk factors, no risks had been identified. Care plans must provide consistent and accurate information on the identified needs of residents and ensure these are being met correctly by the service. This is Requirement 2. Care plans viewed on the unit providing care for individuals with dementia, provided good information on meeting the specialist care needs of people living with dementia. During the inspection, the inspector spent time on the unit observing how the care staff looked after residents. All members of staff were wearing their name badges and large signage was displayed around the unit. Staff were observed to be interacting positively with residents, talking to residents, maintaining eye contact, talking slowly and in a manner which was appropriate to the communication needs of residents. Residents were also observed to be involved with the running of the home. One resident was seen to help a member of staff fold laundry, as this is what she enjoyed. Other residents were seen to be involved sensory activities, and were seen listening to music, playing games and a group were also smelling different aromatherapy oils, which they all seemed to be enjoying. The documentation/ health records relating to pressure care areas; management of diabetes, falls were examined. The records for these were found to be detailed and were adequately maintained. There was evidence that care plans were being reviewed at least monthly. Risk assessments are routinely undertaken for all residents around nutrition, manual handling, continence, falls and pressure care areas and are reviewed on a regular basis. Monthly weight checks were undertaken for all residents and appropriate action being taken where necessary. Records indicated other health professionals such as the district nurse, optical, dental and chiropody services saw residents. The district nurse visiting the home was spoken to as part of the inspection. She spoke very highly of the home and stated “This is one of the better homes, the staff are knowledgeable and we are always contacted promptly. If we request anything for residents, they will get it straight away. I am always consulted and kept informed of residents’ progress.” Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 Page 12 The accident and incident book was reviewed. Accidents were recorded in full, and residents received follow up checks to ensure there were no further health associated risks, and follow up sheets were completed, which were counter signed by the registered manager. The Commission for Social Care Inspection in line with Regulation 37 has been informed of these accidents. All care plans viewed contained information on the end of life wishes of residents and the contact details of relatives and representatives where appropriate. There are policies and procedures for the handling and recording of medicines. An audit was undertaken of the management of medicine within the home and a random sample of Medication Administration Records (MAR) charts were examined. The following issues were discussed with the manager of the home. Controlled drugs were not stored in a controlled drugs cupboard. Medication Administration Records repeatedly included the incorrect code where medication had not been given. The code A, which indicated the resident had refused medication, was used repeatedly. On speaking to staff regarding a medication to relieve constipation, staff informed the resident had not refused the medication but they had not given it to them due to an episode of loose stools. The code O should have been used on the Mar Chart, to indicate why the medication was not given. Staff must also record on the MAR sheet the date, the name of the medication and a description of why the code was used and the statement to be signed by the member of staff making it. Medication was secondary dispensed into dosette boxes by staff for residents, when leaving the home. If the home fills medicine containers or compliance devises then a written policy is required that includes the procedure to be followed and the precautions to be taken, including a witness to the transfer. A fully documented record of the transfer would need to be retained and signed by staff involved. The procedure would need to include the staff trained as being authorised to transfer medication and they will require contacting their pharmacist for advice before transferring medication as the transfer of some medicines from the manufacturer’s packaging is contraindicated. A signature of the person accepting receipt and return is required. It is Requirement 3 that medication practices are reviewed to ensure the safety of residents. - - All the residents spoken to, spoke very positively regarding the care they received at the home. Comments included “I’ve been at the home for two years, and I couldn’t have done any better. Everybody here is very Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 Page 13 considerate, and the carers are very good to me.” Another resident stated, “The staff are very good, some of them are darlings and we get what we ask for.” Further comments included “Its ok here, they are all ok.” “I can’t complain, I am happy here, I have never had any problems, the carers are very good.” Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a varied programme of activities available and residents are given the opportunity to take part in a variety of activities, which meet their recreational needs. However, staffing levels sometimes inhibit residents from going out, which therefore need to be reviewed. There is a choice of meals in the home, but these do not always meet the needs and choices of all residents. Visiting times are flexible and people are made to feel welcome in the home, so that residents are able to maintain contact with their family and friends as they wish. EVIDENCE: The service employs two activity co-ordinators who are responsible for organising activities for all residents at the home. There is a weekly activity sheet displaying all planned activities on each unit during the week. Residents Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 Page 15 can join other residents on other units to participate in the activities of their choice. Activities included, games, quizzes, bingo, and exercise classes. There was also a library service available to residents and numerous entertainers were invited to the home. Trips out are organised regularly and on the day of the inspection some residents were being supported to go out tea dancing. However, one resident spoken to, felt that due to low staffing levels he could not always be supported to go out. He stated “I have to wait a long time if I ask to go out, as they don’t have enough staff.” A relative spoken to also highlighted the same concern and stated, “If my dad wants to go to the bank, it takes time for staff and just doesn’t happen straight away, as they don’t have enough members of staff on to help my dad to do this”. It is Requirement 4 that the service reviews its staffing levels, to ensure there are sufficient numbers of staff on duty to meet the needs of residents. On the unit providing care for residents with dementia, residents were seen to be involved in sensory activities. They were seen listening to music, playing games and a group were also smelling different aromatherapy oils, which they all seemed to be enjoying. A music collection of CD’s was seen on the unit and a collection of old time movies was also in the process of being collated for residents to watch. All members of staff providing care on the unit had undergone training in dementia. The menu was seen which included a variety of fresh fruits and vegetables and a choice of two meals at lunchtime and snacks throughout the day. Records were seen of residents’ choices of meals for each day that they had chosen when consulted by carers, and the cook was seen preparing salads for three residents for their lunch, as they did not want the choices offered on the menu. On speaking to the cook, she was able to demonstrate her knowledge of those residents requiring special diets, for example diabetic and pureed diets. The service does have a guide to meal times but clearly states in its Service User Guide that “Times are a guide only and may be changed at a resident’s request”. Evidence was seen of the service practicing this statement. On the inspector arriving at the home, residents were seen to be having breakfast at different times and some residents were just getting ready to have their breakfast. On touring the home it was observed that the menu was not displayed around home, to ensure residents were kept informed of the choices available for the day and the week. On the unit providing dementia care there was no evidence of pictorial menus displayed, which would more be appropriate to the communication needs of residents on this unit. It is Recommendation 2 that the menu is displayed around the home to ensure all residents are aware of the choices of meals available and is provided in pictorial formats for residents on the dementia unit. On asking residents what they thought of the meals provided, a mixed response was received. One resident stated, “Since I’ve been here my appetite has come back, and the food is good. I went to the local pub Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 Page 16 for roast beef on Sunday and then had it here, it was a lot better here. I can’t eat eggs and they have been very good at offering me alternatives, they really do serve you well here.” However, some residents and relatives expressed dissatisfaction on the quality of meals provided at the home. One resident stated, “The meals are drab, they do offer two choices of meals, but if I feel like steak and chips, I feel they are too busy for me to ask.” Another relative spoken to stated, “I have seen the meals and they are dreadful”. Another relative spoken to stated “My mother is Spanish and it would be great if they could provide Spanish meals as this is what my mother eats. The home hasn’t made an effort to cater for her diet.” The service must ensure the dietary needs and choices of all residents are met and meals provided also ensure that residents’ cultural dietary needs are catered for. This is Requirement 6. The inspector spoke to residents regarding their daily routines; a mixed response was received. One resident spoken to stated, “In theory we can go to bed what time we want but in practice we fall into the drill. I go to bed at about 8.30pm every night and I have to fight for this, as the daytime staff are expected to put me to bed before they go.” Another resident spoken to stated “I can go to bed whatever time I like, I am naturally a early riser but that is the time I like to wake up.” On case tracking the care plan for the first resident, preferred daily routines were not specified in detail and stated “Y tells staff when he wishes to go to bed and when he wants to get up”. Residents must be consulted on their preferred daily routines and this is documented in detail in their care plan and in agreement with residents, to ensure residents are helped to exercise choice and control over their lives the way they prefer. This will be stated as Requirement 7. Visiting times are flexible and visitors commented that staff “Make them feel welcome, at any time.” Residents are able to receive visitors in their own rooms, in the lounges or in the quiet lounge. Parkview House DS0000061980.V346889.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, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives can be confident that their written complaints will be listened to and acted upon. However, records of verbal complaints or concerns were not seen, and did not ensure complaints about the care of service users, regardless of source or how they are made, were investigated and responded to. There is a comprehensive adult protection-training programme for staff, which ensures residents are protected from abuse. EVIDENCE: The complaints procedure is clear, concise and easy to follow and was displayed in the entrance of the home. A complaints logbook is kept by the home, which was viewed. There were two recent written formal complaints logged, one of which was also made to the Commission for Social Care Inspection. The service was informed of the complaint, and has investigated the concerns highlighted satisfactorily. The home also holds regular residents’ meetings and records seen demonstrated that all concerns raised by residents Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 Page 18 were listened to and actioned. One resident spoken to informed that she has made a complaint and her complaint was dealt with immediately, and that she was very satisfied with the way the home dealt with it. However, evidence was not seen of verbal complaints or concerns recorded by the service. All complaints about the care of service users, regardless of source or how they are made, must be recorded and thoroughly investigated and responded to. This will be stated as Requirement 2. All staff attend POVA training and adult protection is comprehensively covered in the induction programme. The service has comprehensive adult protection procedures and protocols in place. Staff spoken to at the home were able to demonstrate their understanding of adult abuse policies and procedures. Upon entry to the home, the inspector had been invited to sign the visitor’s book, to ensure the safety of residents. Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean, well maintained, decorated and furnished to a good standard. However, residents may be at risk due to infection control issues. Adequate storage of cleaning equipment and wheelchairs must be found other than the home’s bathrooms, to ensure residents have access to a safe environment. EVIDENCE: The premises were comfortable, bright, airy, clean and free from offensive odours. Furnishings and fittings in communal areas were of good quality, domestic and unobtrusive. The home provides a homely environment to meet the needs of service users. One relative spoken to described the home as Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 Page 20 “Very good”. A further resident commented, “My family only chose this home, because it was so clean and tidy.” The home has four units which each has a lounge and kitchen area. The grounds around the home were well maintained and were equipped with suitable garden furniture. Residents’ rooms were seen during the inspection, which were comfortable with adequate furnishings and was also personalised by residents with personal family photos and furniture. All rooms were lockable and can be overridden by staff in an emergency. On the dementia unit, signage and décor was appropriate to the needs of residents living with dementia. Toilets had appropriate signage, which were in colour and large print. There was a large clock displaying the time of day and there were appropriate pictures in the corridors and lounge area. The unit was bright and comfortable. During a tour of the building it was identified that some bathrooms were being used to store wheelchairs and on the unit providing dementia care, mop equipment was stored in the shower room. This poses a health and safety hazard to residents who are confused and disorientated. Household hazardous products were also found in an unlocked cupboard under the kitchen sink and food found in some fridges on each unit was not adequately labelled with the date of opening and not all food was stored in airtight containers. Staff did not consistently complete a log of fridge temperatures seen on some units, and no recordings were found for some days. The service must ensure that it does not pose risk in relation to infection control and health and safety. This is Requirement 9. Parkview House DS0000061980.V346889.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, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment practices are robust and ensure residents are in safe hands at all times. Adequate staff training is provided to all care staff, to ensure they are equipped with the skills and are competent to do their jobs. However, some activity co-ordinating staff had not received training in dementia, which did not ensure they were equipped with skills and knowledge to meet the needs of residents at the home. EVIDENCE: Three staff files were closely examined, which were all in good order. References and Criminals Records Bureau checks had been obtained for all three members of staff. Staff had been on induction programmes and all received ongoing training. Training received included training in protection of vulnerable adults, dementia care, handling, storage and the administration of medication, moving and handling, food hygiene, and fire awareness. However, on speaking to the activities co-ordinator on duty who arranged activities for residents with dementia, she informed that she had not been on any training in dementia. It is Requirement 5 that all persons employed at the care home receive training appropriate to the work they are to perform to ensure they are equipped with the skills to meet the needs of residents. Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 Page 22 The service has a permanent staff team and does not use agency staff, which ensures a consistent service being provided to residents. Staff qualifications evidenced that the service has a ratio above 50 of NVQ qualified staff. The staffing levels throughout the care home need to be reviewed as some residents and relatives spoken to felt that staff were rushed. One resident spoken to stated “Staff are very rushed in the morning, I would double the staffing levels at the home.” Another relative stated, “If my dad wants to go to the bank, it takes time for staff and just doesn’t happen straight away, as they don’t have enough members of staff on to help my dad to do this”. Adequate numbers of staff must be on duty to ensure the health and welfare needs of all residents are met. Please refer to Requirement 4 under standard 14 of this report. Parkview House DS0000061980.V346889.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, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that the staff team who care for them benefit from regular supervision. Service users benefit from a manager who is fit to be in charge. Service users’ financial interests are not always safeguarded. The systems for service user consultation must also include views from stakeholders to ensure the home is run in the best interests of residents. The welfare of staff and residents is promoted by the home’s policies and procedures. Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 Page 24 EVIDENCE: The registered manager has been employed at the home for 11 years and has acquired her registered managers award and a level 4 NVQ qualification. Staff spoken to spoke very positively about the manager of the home. Comments includes “The manager’s door is always open, we can easily talk to her.” A resident spoken to stated, “The manager is very good, this is a wonderful home and my health has improved so much since being here.” The service is responsible for the finances of one resident. The resident’s records of money held were checked with the money held in safekeeping, which was found to be incorrect. The amount counted held by the home was more than the balance recorded. The manager must check the recordings of expenditure to find where the mistakes have been made and address this with the administrator as a matter of urgency. This is Requirement 10. Quality Assurance systems are in place, and questionnaires completed by residents and relatives were seen. The home should include health professionals, Social Services and any other stakeholders in contact with the home to ensure their views are sought on how the home is achieving goals for residents. The results must be communicated to residents, family and stakeholder and a copy of the results must be made available to the Commission for Social Care Inspection. This will be stated as Recommendation 3. Staff supervision records evidenced that staff were supervised at least six times a year and to ensure staff are provided with the skills, training and knowledge to perform the tasks required by their employment role. Health and Safety records were inspected. All documentation was in order and appropriately completed. Fire drills were completed regularly and minutes were seen of the home holding regular health and safety meetings, to ensure all health and safety issues were highlighted and dealt with. Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 Page 25 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 3 3 N/A 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 3 13 2 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 3 3 3 3 3 2 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 3 X 3 Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation Sch 1 45 Requirement The registered persons must ensure the Statement of Purpose provides all the information required by the Care Homes Regulations 2001. The registered persons must ensure care plans provide consistent and accurate information on the identified needs of residents and ensure these are being met correctly by the service. The registered persons must ensure all controlled drugs are kept in a controlled drugs cupboard; Medication Administration Records are recorded correctly and the correct procedures are followed for all medication leaving the home. The registered persons must ensure the service reviews its staffing levels, to ensure there are sufficient numbers of staff on duty to meet the needs of residents. The registered persons must ensure that all activity coDS0000061980.V346889.R01.S.doc Timescale for action 30/10/07 2 OP7 12 13 15 30/10/07 3 OP9 13 30/10/07 4 OP27 18 30/10/07 5 OP28 18 30/10/07 Parkview House Version 5.2 Page 27 6 OP15 16 7 OP14 12 8 OP16 22 9 OP25 OP26 23 10 OP35 Sch 4 ordinators employed at the care home receive training appropriate to the work they are to perform to ensure they are equipped with the skills to meet the needs of residents. The registered persons must ensure the dietary needs of all residents are met and meals provided also ensure that residents’ cultural dietary needs are catered for. The registered persons must ensure residents are consulted on their preferred daily routines and this is documented in detail in their care plan and in agreement with residents, to ensure residents are helped to exercise choice and control over their lives the way they prefer. The registered persons must ensure all complaints about the care of service users, regardless of source or how they are made, must be recorded and thoroughly investigated and responded to appropriately. The registered persons must must ensure that it does not pose risk in relation to infection control and health and safety. The registered persons must ensure all recordings of expenditure are correct and in line with the amount in safekeeping for residents. 30/10/07 30/10/07 30/10/07 30/10/07 30/10/07 Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 Page 28 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 It is recommended the service considers providing the Statement of Purpose and the Service User Guide in formats such as Braille, appropriate languages, pictures, video and audio. It is recommended that the menu be displayed around the home to ensure all residents are aware of the choices of meals offered at the home and it is provided in pictorial formats for residents on the dementia unit. It is recommended that the results of quality assurance surveys are communicated to residents, family and stakeholder and a copy of the results must be made available to the Commission for Social Care Inspection. 2 OP15 3 OP37 Parkview House DS0000061980.V346889.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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