Inspection on 12/05/06 for Parkview Nursing and Residential Home

This inspection was carried out on 12th May 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Parkview Nursing and Residential... 16/07/08

Parkview Nursing and Residential... 09/08/07

Parkview Nursing and Residential... 25/07/05

Parkview Nursing and Residential... 24/01/05

Parkview Nursing and Residential... 09/01/05

Parkview Nursing and Residential... 04/08/04

Parkview Nursing and Residential... 25/02/04

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Keer Sands Residential Home

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Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Parkview Nursing and Residential Home 54 Chorley New Road Bolton Lancashire BL1 4AP Lead Inspector Mike Murphy Key Unannounced Inspection 12th May 2006 09:30 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 Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 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 Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Parkview Nursing and Residential Home Address 54 Chorley New Road Bolton Lancashire BL1 4AP 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) 01204 363105 01204 361779 Jewelglen Limited Ms Angela Williams Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (35), Physical disability (6) of places Parkview Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 41 service users, to include Up to 35 service users in the category of OP (Older People): Up to 6 service users in the category PD (Physical Disabilities under 65 years of age), one of whom is a named service user. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 9th January 2006 2. Date of last inspection Brief Description of the Service: Parkview is owned by Mr M K Raja and is managed by Mrs A Williams. Care services are provided in a large adapted property built on three levels with a passenger lift to all floors. The home provides 41 places for the care of elderly people including six places for people with a physical disability. The home which has garden areas to the front and rear, is situated on Chorley New Road about one mile from Bolton town centre, is close to main bus routes and there are shops within walking distance. The current fees for residential care is £354.04 (with nursing fees being structured in accordance with PCT assessment) – information supplied by the provider. Parkview Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection visit took place over a period of six hours. The inspection included discussion with residents, relatives, and visiting healthcare professionals, a tour of the premises, inspection of care and other records maintained at the home, and discussion with the provider, manager and staff. The home was being appropriately managed and provided residents with a clean and comfortable environment in which to live. Residents were supported and cared for appropriately and encouraged to make personal choices and retain as much personal independence as possible. What the service does well: What has improved since the last inspection? What they could do better: Whilst there have been significant environmental improvements there are still a significant number of bedrooms that still require redecoration and refurbishment of some of the furnishings. Also the ‘smoking’ lounge is heavily stained with cigarette smoke and has not yet been redecorated. Comments made over the course of the inspection indicated that many (both residents and relatives) thought the communal lounge areas needed to be more personalised and homely for example by the addition of pictures/ornaments Parkview Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 Page 6 etc. The home will be required to submit an action plan (to include timescales for action) to the CSCI detailing how they propose to address these issues. 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 Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 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 Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5. Standard 6 does not apply to this service. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents are provided with the information they need to make an informed choice about where to live and the views of resident’s are central to the process of admission to the home. EVIDENCE: All prospective and existing residents are provided with a ‘service users guide’ that includes a range of information about the home, the services provided, the experience and qualifications of the staff, the most recent inspection report, and how to complain about the service if necessary. Residents spoken to were aware of this document (as were the relatives spoken to) and that a copy was in their room. A written contract is provided to all residents admitted to the home that details the terms and conditions of occupancy. Parkview Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 Page 9 All potential residents have their needs assessed prior to admission by the home manager – who is also a qualified nurse. This ensures that the home is able to meet the potential resident’s needs appropriately. Discussions with residents, relatives, and the manager indicated that the whole admission procedure is aimed at ensuring resident’s admission to the home is monitored closely and that the resident’s experience is as less stressful as possible. Comments made to the inspector included ‘ I felt that my views were listened to it was decided I needed to go into a home to be cared for’, ‘The matron came to see me before I came and then I was able to visit the home a couple of times before I came in’, ‘my mum has been properly looked after since coming to Park view and we had a meeting after she was admitted to see if things were working out ok – which they are’. Parkview Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The health and personal care residents at the home receive is appropriate and is meeting the expectations of residents and their relatives. EVIDENCE: The care records of 3 residents were inspected. These contained care plans that were initially based on the pre-admission assessment that is referred to earlier in this report. Care plans addressed the health, personal and social care needs of residents and were formally evaluated at least monthly. Risk assessments, that seek to protect resident’s health and safety were also recorded in respect of residents skin integrity, mobility, and nutrition (including weight monitoring) and other relevant areas and were also evaluated at least monthly. All residents are registered with a local GP and it was evident that all were assisted in accessing optical, chiropody, dental, district nurses and other Parkview Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 Page 11 specialist services as they required. Relatives were of the view that they were kept informed of all significant changes in their relation’s condition. The procedures for the receipt, recording, storage, handling, administration and disposal of resident’s medicines were appropriate. The qualified nursing staff, are responsible for all aspects of managing medication in the home. Medication administration records had been completed appropriately. Discussion with residents revealed that they felt they were treated with respect and that their right to privacy was upheld. Comments made included; ‘the girls always knock on my door before they come in’, ‘I was asked what I wanted to be called when I first came here’, ‘the staff make sure you feel you are an individual person and speak to you nicely’, ‘the doctor sees me in my own room when he comes’. Parkview Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents felt that they were supported by staff to participate in social activities and are able to retain the ability to make personal choices. There was a general satisfaction with meals provision at the home. EVIDENCE: A record of leisure activities provided and participated in is maintained for each resident. These records reflected that activities are varied and include occasional entertainers coming to the home and trips out. Discussion with residents identified the things they enjoyed and they also felt they were enabled to participate or not as they chose to do. Residents were also of the view that the routines of daily life were as reasonable as possible – it was evident on the day of inspection a significant number of service users had either chosen to get up later in the morning, spend time in their rooms or use the communal lounges as they wanted to. Residents and their relatives report no unreasonable restrictions to visiting at the home which take place in communal areas or resident’s bedrooms. Service Parkview Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 Page 13 users are encouraged to maintain contact with local community – eg local churches, local schools visiting the home. Resident’s indicated that they are actively encouraged/enabled to retain as much personal autonomy and make personal choices in their daily lives at the home and many have brought a number of personalise items to individualise and personalise their rooms. Meals are cooked on site in the home’s kitchen. Menus are varied and balanced. Whilst it was evident that in practice an alternative to the menu is willingly provided the displayed menu does not reflect that choices are available. This was discussed with the manager at the time of inspection. Meals are served in an appropriate dining area although it is noted that some of the dining table legs are quite marked in places and in need of attention. Residents were of the view that meal times are reasonable and as flexible as they can be in such a setting. Lunch was observed on the day of inspection. This was a hot and substantial meal and staff assisted and served residents their meals appropriately. Residents indicated that they were generally happy with their food provision. Comments made by residents included ‘ you get plenty to eat and its good’, ‘I do enjoy the food here – its good plain food’, ‘although the food is pretty good I would prefer if we didn’t have as many chips’. Parkview Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for 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 the service. Residents and relatives spoken to felt comfortable enough to and knew how to make a complaint if they felt it necessary. Written guidance and training arrangements ensure that staff members have a good knowledge of abuse and protection arrangements and safeguards in place to protect the welfare of residents. EVIDENCE: The complaints procedure was prominently displayed and also is available in the ‘Service users guide’ that is provided for resident’s information. Residents spoken to stated that any concerns or worries brought to the manager’s attention are responded to quickly and rarely become formal complaints. A complaints log/incident log is maintained. There were no complaints logged since the last inspection (January 2006). Park view operates an ‘abuse and whistle blowing’ policy that seeks to protect elderly persons. In addition, a copy of Bolton’s Inter agency protection procedure is held on site. Staff spoken to confirmed that they had received training and were aware of the whistle-blowing policy. Discussion with the manager revealed that she was looking at how to extend and update staff training (as part of the home’s training development programme) in this important area of protection. Parkview Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,24,26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Whilst the home appeared to be structurally well maintained and some decorating issues have been addressed since the last inspection a number decorating issues remain. EVIDENCE: A number of bedrooms have been redecorated since the January 2006 inspection and a new carpet has been laid in the foyer area of the home. Communal areas were clean and residents appeared to be comfortable in their environment. Thre is a communal lounge, smoking lounge and dining room available for service users to use. the lounge area has been repainted but Comments made over the course of the inspection indicated that many (both residents and relatives) thought the communal lounge areas needed to be more personalised and homely for example by the addition of pictures/ornaments etc. The home will be required to submit an action plan (to Parkview Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 Page 16 include timescales for action) to the CSCI detailing how they propose to address these issues. The smoking lounge is still in need of redecoration and a number of bedrooms still require redecoration. Bathrooms were clean and appropriately equipped/adapted. The home was very clean and free of malodour at the time of inspection and was adequately heated and ventilated. A spacious garden area is provided and is accessible to residents and provides a pleasant area for residents to use in nice weather. Parkview Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Resident’s expressed the view that staff were meeting their needs appropriately and staff are subject to an appropriate recruitment procedure that is consolidated by appropriate training when appointed. EVIDENCE: Inspection of staffing rotas provided by the home indicated that staffing provision at the home complied with the current minimum requirements that apply to care homes for older people. Discussion with management at the home indicated that they were of the view that staffing levels were appropriate to meet the dependency levels of resident’s. Inspection of 3 staff personnel files revealed that these contained an application form (including health declaration), 2 written references, details of work permits (where applicable), a Criminal Records Bureau check (including a ‘POVA first’ check), proof of identity and evidence of induction training. It is noted that all care staff at the home, except one who possesses an NVQ2, were adaptation nurses awaiting registration with the Nursing and Midwifery Council and therefore are qualified in excess of the NVQ2 requirement of standard 28. Parkview Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 Page 18 A record of staff training is maintained and reflect that a range of appropriate training has been provided for staff that supports them in caring for residents appropriately. The manager informed the inspector that she was planning future training to update staff in a variety of topics – particularly health and safety issues and adult protection.. Parkview Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 31,35,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Park view is well managed by a manger who is a registered nurse of many years experience in general nursing and care of the elderly. EVIDENCE: Residents and their relatives spoke positively about the manager being accessible, approachable and very supportive. They said their concerns or worries were addressed speedily and appropriately and in a way that made them feel happy to express their views. The arrangements for the management of residents personal allowance monies (where these are managed by the home) were secure and appropriately Parkview Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 Page 20 documented. Residents told the inspector that they were able to access monies when they required them. Records in respect of fire safety equipment, fire drills and fire safety training for staff, gas soundness, the passenger lift, electrical safety, lifting equipment, clinical waste removal and the regulation of water temperatures were inspected. These were found to be satisfactory. Accidents at the home were appropriately documented and appear to have been appropriately managed. The inspector had been informed at the last inspection that the requirements made by the fire safety officer at his last inspection of the home had been complied with. The home was last subject to an environmental Health officer’s inspection of the kitchen in August 2005 – this was satisfactory. Parkview Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 3 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 3 X X 2 3 3 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 x X 3 X X 3 Parkview Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP1 OP15 Regulation 5 (1)(2) 16 Requirement Timescale for action 31/07/06 3 OP19 16, 23 That a copy of the updated Service Users Guide is submitted to the SCSI That menus are amended 31/07/06 (following consultation with residents) to reflect choice and a copy of the amended menu submitted to the CSCI That an action plan is submitted 31/07/06 to the CSCI that details (including proposed time scales) the planned programme for the outstanding/remaining redecoration of bedrooms and replacement of relevant bedroom floor coverings/furniture, the redecoration of the ‘smoking’ lounge and how communal areas are to be made more personalised. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Parkview Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 Page 23 No. Refer to Standard Good Practice Recommendations Parkview Nursing and Residential Home DS0000005693.V288797.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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. 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