Inspection on 08/03/07 for Parkview Lodge

This inspection was carried out on 8th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Lodge 23/08/07

Parkview Lodge 11/08/06

Parkview Lodge 24/02/06

Parkview Lodge 22/11/05

Parkview Lodge 14/09/04

Parkview Lodge 26/04/04

Parkview Lodge 02/01/04

Similar services:

Claremont House

Oak Ridge

Coopers Mill Ltd

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Paradise Lodge

Bilney Hall

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

CARE HOMES FOR OLDER PEOPLE Parkview Lodge 2 Park Avenue Bedford Bedfordshire MK40 2JY Lead Inspector Katrina Derbyshire Unannounced Inspection 8th March 2007 08:55 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 Lodge DS0000014946.V329876.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 Lodge DS0000014946.V329876.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parkview Lodge Address 2 Park Avenue Bedford Bedfordshire MK40 2JY 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) 01234 219620 gaetano.tramunto@btinternet.com Mr Gaetano Tramunto Mrs Antonietta Tramunto Mr Gaetano Tramunto Care Home 14 Category(ies) of Dementia - over 65 years of age (14), Learning registration, with number disability over 65 years of age (14), Mental of places Disorder, excluding learning disability or dementia - over 65 years of age (14), Old age, not falling within any other category (14), Physical disability over 65 years of age (14) Parkview Lodge DS0000014946.V329876.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th August 2006 Brief Description of the Service: Park View Lodge was originally registered in 1986 to provide care for people over 65 years of age. The home caters predominantly for Italian speaking older people. The home is located in a pleasant residential area of North Bedford, opposite Bedford Park and within walking distance of small local shops, pubs and places of worship. The building has been converted from a three storey Victorian House and provides communal living space on the ground floor and bedrooms are provided across all three floors. A passenger lift has been installed to access the varying levels in the home. Parking is available at the rear of the home this is located next to a smallenclosed garden that maybe accessed by the residents from the living/dinning area. The fees for this home are £425.86 per week. Parkview Lodge DS0000014946.V329876.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this visit was to undertake a key inspection. This unannounced visit was carried out on 8th March 2007. The manager Mr. Tramunto was present throughout the inspection. During the inspection all areas of the home were visited and the inspector spent time with many of the residents’ in one of the sitting areas of the home. The care of two residents’ was examined by looking at their records and interviewing the residents’ and staff who look after them. Information from the home had previously been provided and included documents relating to meals, staff training and activities to assist in assessing the outcomes within each standard. In addition the home has submitted an improvement plan to the Commission for Social Care Inspection. Evidence used and judgements made within the main body of the report include information from this visit, feedback from residents and the homes submission of documentation. Observations of care practice and communication between the residents’ and staff was also made at the inspection. The focus of this inspection was to look at the key standards and to follow up on previous requirements. What the service does well: We last visited this home in August 2006 and we said at that time that the home was good at managing medication on behalf of the residents and this still continues. The staff orders and manages medication on behalf of the residents in a safe way. They are organised in the way they order so there is always a stock of medication for each resident that has been prescribed. The medication is also stored correctly making it safer for the residents and the records that the home keeps are of a good standard, to show when a medicine has been given. The standard of cleanliness at the home also continues to be good. The two sitting areas and residents own rooms were seen to still be kept clean, tidy and there have no unpleasant odours in the home. Staff also make sure that any waste is disposed of safely and this makes sure that the levels of hygiene in the home are to a level that makes it safer for the residents. The staff at the home have also developed a good working relationship with the District Nurses. We spoke to one of the nurses visiting the home who said, Parkview Lodge DS0000014946.V329876.R01.S.doc Version 5.2 Page 6 “We come here everyday, if anyone needs are help the staff just ask”. This means residents benefit from the specialist advice, help and treatment from this group of healthcare professionals. What has improved since the last inspection? What they could do better: The manager at the home still needs to start a course on managing a care home; we made a requirement about this in 2005. This course is about understanding management and care to a level that is needed by anyone who runs a care home. The manager must now look at undertaking more training to help him understand how to improve the way that care is delivered at the home to make it better for the residents. The way staff offer support to some residents needs to change. One resident at the home was being shaved in the lounge in front of the other residents, and the razor being used was not their own. This needs to be done in the privacy of their own room and razors must not be shared. This practice does not treat the resident with dignity or respect and is not acceptable. The management at the home also need to keep copies of the responses that they give to people when they have raised a complaint. They need to show that the person that has raised the concern has been satisfied with the action, and response taken by the home. The manager also needs to look to see if any of the complaints have similar themes. Two of the most recent complaints raised concerns on the approach of staff. Parkview Lodge DS0000014946.V329876.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Parkview Lodge DS0000014946.V329876.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 Lodge DS0000014946.V329876.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessment systems are now sufficient to ensure the home has the information so that an informed decision can be made as to whether the home is able to meet a residents needs. EVIDENCE: Assessments were seen within the care records of the residents. The information seen gave information using both a tick format and summary. The information in place gave an overview of the physical and social needs of the resident. A further document had then been written that described the background of the person and what they had done in their lives and included information on those people who were important to them. In addition information from the funding authority was also seen to be kept within the care records, providing additional information about the resident. Parkview Lodge DS0000014946.V329876.R01.S.doc Version 5.2 Page 10 Intermediate care is not provided at this home. Parkview Lodge DS0000014946.V329876.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The delivery of personal care for some residents does not uphold their dignity. EVIDENCE: It was observed when the inspector first arrived that one of the residents was being shaved by one of the staff in the lounge area of the home. This was in front of other residents. The shaver being used was then placed in a cupboard in this area. Through discussion with the manager at the home and a staff member it was confirmed that this shaver was used for other residents. A shaver was not kept in a resident’s room as the manager stated that staff would not keep them clean. A requirement is made in this area. Parkview Lodge DS0000014946.V329876.R01.S.doc Version 5.2 Page 12 Care plans examined showed that an improvement in the standard of care plans actually in place had taken place since the homes previous inspection. One resident’s care documents had been completely revised. New care plans in typed form had been developed alongside revised risk assessments relating to pressure care and nutrition. There was a plan for each assessed need for this resident and the guidance to staff was sufficient for them to know the care that should be provided. However another resident had been living at the home for over three weeks. There were no plans in place for this person, the manager stated that he had not yet had time to do these as there had been another admission and he had done the plans for that resident first. This placed the resident at risk, as there was no guidance to show the care that they need, the three-week delay is not acceptable. It was observed sufficient equipment was present in the home to maintain pressure area care for the residents. Care records contained documentary evidence to support that access to external healthcare professionals, for example chiropody, dentist, General Practitioner and optician took place. Medication records contained information relating to prescribed medications past and present. Entries on these documents matched the homes medication administration records and medication stocks for the residents. The drug fridge was kept locked, and appropriate checks made on the temperature. Parkview Lodge DS0000014946.V329876.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. 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. The meals provided at the home meet the cultural preferences of the residents. EVIDENCE: Information within the homes statement of purpose continues to describe the services available at the home as ‘specialising in care for the Italian community’. The home was noted to provide a diet that reflected the cultural tastes of the resident’s and television in the home shows Italian-speaking channels. Several residents confirmed that the home arranged for them to continue to practice their chosen faith, through arranging for representatives of the local church to visit. Care plans in place for one resident whose care was case tracked showed the individual social emotional or cultural needs of the resident. Visiting times at the home are set, information on visiting arrangements is provided prior to a decision on any admission to the home. However the Parkview Lodge DS0000014946.V329876.R01.S.doc Version 5.2 Page 14 management of the home may wish to reconsider this as there are other areas in the home visitors could wait in, whilst their relative was having their meal. Residents are able to receive visitors within their bedrooms or in the lounge areas. This information is made available to all prospective residents and their families prior to admission to the home. Information relating to the residents families and friends were seen within the care records and staff confirmed that this was used to support the residents in maintaining their own personal relationships. Meals at the home continue to reflect the cultural tastes of the resident’s and the lunch served at the time of the inspection-included protein, carbohydrates and vegetables. Residents said that the meals at the home were acceptable in their standard and they felt that they had a sufficient amount. Parkview Lodge DS0000014946.V329876.R01.S.doc Version 5.2 Page 15 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 adequate. This judgement has been made using available evidence including a visit to this service. Improvements are needed in the way the home responds to complaints to ensure residents and their families feel that their concerns are listened to and acted upon. EVIDENCE: The homes policy for the protection of vulnerable adults was examined, the policy was comprehensive and included how any incident of abuse should be reported. Staff training records also showed that they had attended workshops on this area and they were able to describe the varying types of abuse, which included physical and financial. A previous requirement for all staff to be trained in this area was noted to have been met. The homes complaints procedure gave sufficient guidance to staff on the action that they should take on receiving a complaint. The procedure described the rights of residents and that all complaints must be responded to. Within the homes statement of purpose a summary of how to complain had been included for residents and their relatives. Written records were seen on complaints that had been received and the investigation undertaken. However it was noted for Parkview Lodge DS0000014946.V329876.R01.S.doc Version 5.2 Page 16 the most recent complaints received there was no copy of the response made. In addition the manager needs to look at any emerging themes from the complaints received at the home as the most recent had elements of staff approach. He should then take action regarding this. Parkview Lodge DS0000014946.V329876.R01.S.doc Version 5.2 Page 17 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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of cleanliness in this home is of a very good standard and provides a pleasant environment for the residents to live in. EVIDENCE: The premise is a converted three-storey house. Accommodation available to residents is across two floors at this time. The furnishings, fittings and décor in these areas is of an acceptable standard. The assessment of these standards was noted to be as stated at the previous inspection. All residents who were seen commented that the environment was pleasant and felt that the home catered well for their needs in this area. The rear garden area provide spaces Parkview Lodge DS0000014946.V329876.R01.S.doc Version 5.2 Page 18 to sit out in the warmer months. Individual rooms contained personal items of the resident to assist in creating a homely atmosphere. All areas visited were noted to clean, tidy and free of odours. Staff were observed to wear suitable protective clothing when carrying out certain activities. Cleaning schedules were in place and clinical waste was disposed of in an appropriate manner and clinical waste contracts are in place. Parkview Lodge DS0000014946.V329876.R01.S.doc Version 5.2 Page 19 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 adequate. This judgement has been made using available evidence including a visit to this service. Systems in place for the recruitment of staff are not sufficient to protect residents and places them at risk. EVIDENCE: At the previous inspection a requirement was made for all staff to have two references in place prior to their commencement at the home. This was noted to have been undertaken. However following examination of staff files, it was noted at this visit that the most recently employed member of staff did not have an application form in place. Therefore it was not possible to evidence if the references in place were those entered on their application or to show if the home had investigated any gaps in their employment history. The manager advised the inspector that the member of staff themselves had the application form and he would ask that they bring it in. This is unsafe and a requirement has been made as it places the residents at risk. Staff training records were also examined and showed that staff had attended a variety of courses and workshops including health and safety, food hygiene Parkview Lodge DS0000014946.V329876.R01.S.doc Version 5.2 Page 20 and management of medication. The induction of new staff now follows the national occupational standards in this area. Staffing rotas submitted by the home showed that the number and skill mix of staff were sufficient to meet the needs of the residents. Residents and staff felt that there were enough staff to care for the residents, it was reported that at times residents would need to wait for assistance if help was being offered to another resident but that this would normally only be for a few minutes. Staff through discussion demonstrated that they were aware of the needs of the residents as recorded within their care records and were able to describe the individual. It was observed however during this visit that the interaction between the staff and residents was limited. The inspector observed staff sitting in the lounge area at a table for over 25 minutes, during this time there was no conversation between them and the residents. The manager felt this was because the inspector was there. However one staff member during this time assisted a resident with moving and gave no explanation as to what they were doing and a requirement has been made. Parkview Lodge DS0000014946.V329876.R01.S.doc Version 5.2 Page 21 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 & 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Management at this home continues to be insufficient to ensure care delivery follows current best practice guidance and places the residents at risk of not receiving all the care they require and achieving positive outcomes in all aspects of their lives. EVIDENCE: The evidence within this area was noted to be the same as assessed at the homes previous inspection. The manager at this home still needs to complete a course on managing a care home; this requirement was made in 2005 for him to achieve a care and management qualification to at least NVQ level 4. The Parkview Lodge DS0000014946.V329876.R01.S.doc Version 5.2 Page 22 home has submitted an improvement plan to the Commission for Social Care Inspection, within this it is acknowledged that one of his sons is undertaking an NVQ level 4 and is planning to submit an application to become the Registered Manager later in the year. Although the standard and format of the care documentation has improved, requirements relating to these had been made over a period of time, this does not demonstrate sufficient competency in resolving this matter. In addition the recruitment of a staff member prior to the receipt of any references at the last inspection and then no application form at this one places residents at risk. The home had sent out questionnaires to relatives and residents to gain their views of the standard of care at the home, those responses seen showed that this had been undertaken in 2005 and 2006. However the home now needs to use this information and show how they have used the feedback received to change and influence the running of the home. No monies are managed on behalf of the residents at this home. Documents pertaining to the management of Fire, environmental Health and internal safety checks were seen. All were up-to-date and demonstrated that required safety measures were in place to meet the relevant legislation in this area. Staff and their training records confirmed that they had been trained in a variety of Health and Safety areas including moving and handling, food hygiene and infection control. Parkview Lodge DS0000014946.V329876.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 3 X 3 X X 3 Parkview Lodge DS0000014946.V329876.R01.S.doc Version 5.2 Page 24 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 OP31 Regulation 9,18 Requirement The registered person must achieve the minimum qualification to manage a care home at NVQ 4 in Care and Management. (Previous requirement timescale of 31/12/05, 30/06/06 and 31/12/06 not met) Timescale for action 30/06/07 2. OP7 12(1)(a), 15(1)(ad) 12(4)(a) & 18 A plan must be in place for all the needs of all the residents to ensure they receive the care and support that they require. Residents must not have their personal care needs met in a communal setting or with a shared razor, this does not meet their privacy or treat them with respect. The manager must maintain evidence of his response to complaints to show that he has listened to and acted upon the concerns raised. He must also demonstrate that he acts upon DS0000014946.V329876.R01.S.doc 30/04/07 3. OP10 30/04/07 4. OP16 12, 13 7 18 31/05/07 Parkview Lodge Version 5.2 Page 25 any similar themes that emerge. 5 OP28 18 & 19 Staff must engage in conversation with residents offering an explanation of what they are doing to ensure residents are treated with respect. The home must have an application form in place to demonstrate that any gaps in employment have been explored and the references on file are those of the most recent employer, to protect the residents. 30/04/07 6. OP29 12(1)(a) & 19 31/05/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP13 Good Practice Recommendations A review of visiting times should be undertaken to stop the restrictions that are in place. Parkview Lodge DS0000014946.V329876.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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. Extracts may not be used or reproduced without the express permission of CSCI Parkview Lodge DS0000014946.V329876.R01.S.doc Version 5.2 Page 27 - 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!