CARE HOMES FOR OLDER PEOPLE
Parkview Nursing Home 1 - 3 Eversley Road London SE19 3PY Lead Inspector
Alison Ford Unannounced Inspection 10th November 2005 11:00a 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 Home DS0000019037.V257134.R01.S.doc Version 5.0 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 Home DS0000019037.V257134.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Parkview Nursing Home Address 1 - 3 Eversley Road London SE19 3PY 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 8771 5234 020 8653 6493 Planshore Limited Mrs Betty Marcellin Care Home 64 Category(ies) of Old age, not falling within any other category registration, with number (64) of places Parkview Nursing Home DS0000019037.V257134.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 4 Intermediate care with the PCT: Rooms 314, 315, 317 Date of last inspection 6th January 2005 Brief Description of the Service: Parkview is a large home, in Upper Norwood, registered with The Commission for Social Care Inspection, to provide nursing care for up to sixty-four residents. The home is located in a residential road opposite a large park and there is off street parking to the front. It is near to local amenities and well served by public transport. Accommodation is provided over three floors in a mixture of single and shared rooms some of which have en-suite facilities. There are a variety of communal areas; a large well maintained rear garden and an attractive small courtyard garden. Parkview Nursing Home DS0000019037.V257134.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the homes first inspection for the year 2005/2006, although two visits had been made regarding other issues. The inspection, which was unannounced, took place over three hours. During this time a partial tour of the premises was undertaken, a sample of care plans were assessed and a selection of records relating to the health and safety of residents and recruitment and training of staff were examined. The Registered Manager was not on duty and the inspection was conducted with her deputy who was welcoming and receptive to the inspection process. Fourteen residents and four members of staff were spoken with during the visit. Prior to the inspection, the Registered Manager had submitted a pre-inspection questionnaire and comment cards had been received which apparently reflected the views of fifty-three residents although they were completed by staff members on their behalf. Three relatives also took the time to complete cards. What the service does well:
This home provides a consistently high standard of care within a well-managed environment. All of those that were spoken to were appreciative of the care that they receive, the homes manager and her staff team. All the residents, met during the inspection process looked clean and well cared for. Comments were made by residents that “staff were very kind” “they were very happy here” “staff treat the residents well” and “ you can do what you want”. A comprehensive pre-admission assessment ensures that the physical healthcare needs of residents will be met and care plans accurately reflect the care that is currently being delivered. Advice is gained from other healthcare professionals as needed. The home is proud of its activities programme and an innovative range of activities suitable for the needs of the residents is provided. This includes outings and entertainment and the celebration of birthdays and other festivals. Residents expressed their satisfaction with the food served in the home and alternative choices would always be made available. All of those spoken to were confident that the management team would deal with any concerns that they might have promptly and appropriately. Parkview Nursing Home DS0000019037.V257134.R01.S.doc Version 5.0 Page 6 Staff training has a high priority in the home and the majority of the care staff have undertaken an NVQ qualification in addition to various other training courses. Acknowledging the increase in dependency of some of the residents, future training will include sessions relating to the problems associated with dementia. Safety practices were generally of a good standard and recruitment policies and procedures were robust. 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. Parkview Nursing Home DS0000019037.V257134.R01.S.doc Version 5.0 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 Home DS0000019037.V257134.R01.S.doc Version 5.0 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): 3,6 A comprehensive pre-admission assessment ensures that the home can meet the healthcare needs of potential residents. . Facilities offered to those admitted for intermediate care ensures that they are supported to return home as soon as possible. EVIDENCE: A sample of care plans were viewed, these contained evidence that thorough and thoughtful pre-admission assessments had been undertaken to ensure that the healthcare needs of potential residents could be met. These then formed the basis for subsequent care planning. Intermediate care facilities are provided on the third floor of the home by appropriately trained staff in conjunction with other members of the multidisciplinary health care team. These include physiotherapists and occupational therapists. Four beds are currently allocated to this service. Parkview Nursing Home DS0000019037.V257134.R01.S.doc Version 5.0 Page 9 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): 7,8,10. The residents in this home are treated in a way, which maintains their dignity and respect. Their health needs are identified and reviewed regularly, using an individual care plan, so that they continue to be met and they are able to access care from additional healthcare services. EVIDENCE: All residents have an individual care plan and a sample of these was assessed during the inspection. There was evidence that these were reviewed regularly to ensure that they reflected the care and support currently being delivered. They showed that other members of the multidisciplinary healthcare team are involved in residents care where necessary and the optician was visiting on the day of the inspection. Regular monitoring is undertaken to identify those at risk from developing pressure sores and appropriate equipment is provided. The medication records were seen however, the current four-week administration cycle had only just started and this will be looked at in depth at a later visit. Personal care is delivered in resident’s own rooms and all those spoken with agreed that staff were kind and treated them well. Comments were received that “it’s a lovely home “ “I like the people here “ and “we are looked after very well”.
Parkview Nursing Home DS0000019037.V257134.R01.S.doc Version 5.0 Page 10 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, Residents in this home are able to participate in an exceptionally good activities programme, which suits their expectations and preferences and provides interest and variation. They are able to make choices within their daily lives, which enable them to maintain their independence for as long as possible. EVIDENCE: Residents confirmed that they are able to choose the clothes that they wear, the activities that they participate in and the meals that they eat. Several residents were in their rooms, watching television or reading and confirmed that this was their preference. One resident commented, “you can always do what you want here “ The home has an extensive activities programme of which it is very proud. Photographs showed various events that had taken place and staff are encouraged to join in to entertain residents with shows and pantomimes. Excursions are arranged regularly and residents were unanimous in their praise of the activities organiser. Comments were made that they particularly enjoyed the musical entertainment and some money raised by the home has been used to buy a karaoke machine. Other equipment purchased has included foot spas after residents expressed an interest in having pedicures and plants and flowers for the courtyard garden which they enjoy sitting in for tea and
Parkview Nursing Home DS0000019037.V257134.R01.S.doc Version 5.0 Page 11 reminiscence sessions. A trolley shop, in the home, allows residents to make small purchases without consulting their relatives and maintain a degree of independence. One pre-inspection comment card had reflected some dissatisfaction with the food however this view was not confirmed by any of the residents spoken to during the inspection. The cook visits residents in the morning to offer a choice of menu and monitors the bodyweights of residents to ensure that the meals served are meeting their nutritional needs. Some care staff are supporting him to introduce West Indian food for those who would like it. Parkview Nursing Home DS0000019037.V257134.R01.S.doc Version 5.0 Page 12 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 The residents in this home can feel confident that any concerns or complaints would be dealt with promptly and sensitively. EVIDENCE: There is a clear complaints policy in use in the home and no complaints have been made to the home since the last inspection. One concern had been received by The Commission earlier this year regarding recruitment procedures and this had been dealt with promptly. Residents that were spoken with said that they felt confident in raising any issues with the nursing and management staff. Parkview Nursing Home DS0000019037.V257134.R01.S.doc Version 5.0 Page 13 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): 19,26 Although residents live in a clean, well-maintained home, which meet their needs in a comfortable and homely way. However their safety could be compromised if staff continue to wedge doors open. EVIDENCE: The home is situated in a residential road and is keeping with other properties in the area. It is attractively presented and well maintained in line with health and safety guidelines. Bedrooms and communal areas are comfortable and well designed and residents have been able to personalise their rooms with possessions from home. Adaptations are in place to meet the needs of the residents and all parts of the home are accessible. There is an attractive rear garden and a smaller courtyard garden, which are both well used in the warm weather and one resident said that they often went into the large park opposite the home. All areas of the home, that were seen, were clean and free from odour. Parkview Nursing Home DS0000019037.V257134.R01.S.doc Version 5.0 Page 14 Although some bedroom doors have been fitted with automatic closers, which operate in the event of a fire, there were still some door wedges in use throughout the home. If residents wish to keep their doors open they must all have these closers fitted. Parkview Nursing Home DS0000019037.V257134.R01.S.doc Version 5.0 Page 15 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 Residents in this home are cared for by well-trained and competent staff who are able to meet their assessed needs, and they are protected by the homes recruitment policies. EVIDENCE: On the day of the inspection the home was well staffed by a mixture of trained nurses, care staff and ancillary staff. Off duty rotas provided evidence that this is always the case. Staff training is given a high priority in the home and records provided evidence that a wide range of training has been undertaken. The employment of trained nurses from overseas, while they undertake adaptation courses, means that trained nurses are encouraged to update their practice in order to deliver appropriate care. In acknowledgement of the problems encountered when employing staff, whose first language is not English, courses are run to improve communication and language skills. Recognising an increase in the dependency of some of the resident’s, future training will include looking at the care of those with dementia. Files of four staff members employed since the last inspection were seen and were all in order and contained all of the required documentation. Parkview Nursing Home DS0000019037.V257134.R01.S.doc Version 5.0 Page 16 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): 33,38 An effective quality assurance system measures the satisfaction of residents and their relatives and health and safety procedures are in place, which ensure their protection. EVIDENCE: A resident’s questionnaire is completed yearly and the results were available for inspection. Services provided by the home and the care that is provided are also subject to regular audit. Staff explained that they had regular meetings and minutes were available and would also be discussed during supervision sessions. The pre-inspection questionnaire provided evidence that policies and procedures and certificates of worthiness of equipment were up to date and a recent visit had been made by the fire safety officer. Staff confirmed that regular fire drills took place and that all mandatory training had occurred. Parkview Nursing Home DS0000019037.V257134.R01.S.doc Version 5.0 Page 17 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 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 X X X X X X 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 X X 3 X X X X 3 Parkview Nursing Home DS0000019037.V257134.R01.S.doc Version 5.0 Page 18 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 Standard OP19 Regulation 13(4)(c) Requirement The Registered Manager must ensure that any bedroom door, that residents wish to leave open, is fitted with an automatic closer, which operates in the event of a fire. Timescale for action 30/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Parkview Nursing Home DS0000019037.V257134.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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