Inspection on 19/10/07 for Parkview Rest Home

This inspection was carried out on 19th October 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 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 Rest Home 22/09/09

Parkview Rest Home 23/09/08

Parkview Rest Home 12/06/06

Parkview Rest Home 27/10/05

Parkview Rest Home 20/07/05

Parkview Rest Home 17/03/05

Parkview Rest Home 02/08/04

Parkview Rest Home 13/02/04

Similar services:

Alderson Road 12

Abbey The

Grayling

Larch Avenue

Cranworth Close Registered Care Home

Muston Road (70)

The Cornerstone

John Street Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Parkview Rest Home 7/8 North Park Road Heaton Bradford West Yorkshire BD9 4NB Lead Inspector Steve Marsh Key Unannounced Inspection 09:30 19th October 2007 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 Rest Home DS0000001299.V346641.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 Rest Home DS0000001299.V346641.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parkview Rest Home Address 7/8 North Park Road Heaton Bradford West Yorkshire BD9 4NB 01274 544638 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) Mrs Susan Linda Crabtree Mr Stewart Leonard Crabtree *** Vacant *** Care Home 23 Category(ies) of Dementia - over 65 years of age (4), Learning registration, with number disability over 65 years of age (2), Old age, not of places falling within any other category (16), Physical disability over 65 years of age (1) Parkview Rest Home DS0000001299.V346641.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th June 2006 Brief Description of the Service: Park View is a detached adapted building that provides accommodation for twenty-three older people requiring residential care. Bedrooms are located on the ground and first floors. There is no stair or passenger lift. The home is adjacent to Lister Park in the Heaton area of Bradford. It is close to local amenities and a bus route. Level access is available to the rear of the property along with a small car park. Well-kept gardens are to the front of the home where people can sit and enjoy the good weather. Current fees are £351:68 per week with additional charges for hairdressing, private chiropody, toiletries etc. Parkview Rest Home DS0000001299.V346641.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out between the hours of 9:30am and 4:00pm. The purpose of this visit was to assess how the home is meeting the needs of people who live there. The manager had only been in post for a week at the time of the inspection and was therefore still familiarising herself with the home and the policies and procedures. The Registered Providers and Area Manager were present at the home for most of the inspection. The methods I used included looking at records, watching staff at work, talking to people living at the home and the manager and staff. Survey questionnaires were sent to people living at the home, relatives and healthcare professionals, so that they can share their views and opinions of the service with us. The previous manager had also completed an Annual Quality Assurance Assessment (AQAA) form and the information provided has been used as evidence in the body of the report. What the service does well: The new manager is committed to providing good leadership to the staff team and making sure people’s rights are protected. The staff have a caring attitude and a good understanding of the needs of the people in their care. The manager and staff create a warm and friendly atmosphere and treat everyone as individuals. Comments from people living at the home included “everyone is caring and will help you in any way they can” and “I am very happy living at Park View.” Comments from relatives included “the staff are very kind and patient with the people in their care” and “the home has a friendly atmosphere and the staff are kind and caring.” Parkview Rest Home DS0000001299.V346641.R01.S.doc Version 5.2 Page 6 The home is committed to having a skilled and experienced workforce and a number of staff have achieved or are studying for a National Vocational Qualification (NVQ) at level two or above. 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 Rest Home DS0000001299.V346641.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 Rest Home DS0000001299.V346641.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 and 3 -- Standard 6 does not apply to this service. People who use the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The admission procedure is not thorough, which means that people could be admitted with needs that the staff are unable to meet. EVIDENCE: The new manager is currently reviewing the home’s statement of purpose, service user guide and brochure to make sure that they accurately reflect the care and facilities available at the home. I looked at the care records for the last two admissions to the home, both of who had been admitted from other care homes, one owned by the same provider. The admissions had been arranged before the new manager had been appointed. Parkview Rest Home DS0000001299.V346641.R01.S.doc Version 5.2 Page 9 I could find no evidence that pre-admission assessments had been carried out before the people had been admitted to the home or that they or their relatives had been anyway involved in choosing to move to Park View. The admission information was very poor and gave no indication as to why the people had moved from their previous care home to Park View or if staff were able to meet their needs. The Area Manager confirmed that a thorough admission procedure had taken place in both cases, however acknowledged that there was no documentation to evidence this. A discussion was held with the Area Manager about the number of people living at the home with dementia as it apparent that this exceeds the four places on the registration certificate. The Area Manager confirmed that many of the people had lived at the home for a number of years and had over a period of time become more confused but had not been diagnosed with dementia. However, it was agreed that at present no further people would be admitted under this category unless a request for a change in registration is made. Parkview Rest Home DS0000001299.V346641.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 and 10 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Care records do not provide accurate and up to date information, which means that people might not be receiving the level of support and care they require to meet their health, personal and social care needs. EVIDENCE: Care plans have been completed for people living at the home and cover all aspects of their social and healthcare needs. Care plans are reviewed on a monthly basis or sooner if there are significant changes in the individual’s circumstances. It was difficult to find some information in the care plans I looked at and information that should have been in the care plans had instead been recorded in the monthly evaluation report or other supporting documentation. In some instances the care plans and monthly evaluation report were contradictory, for example the care plan for one person indicated that their Parkview Rest Home DS0000001299.V346641.R01.S.doc Version 5.2 Page 11 mobility was poor while the most recent evaluation of the plan showed that it was good. Staff cannot therefore rely on the care plans to provide them with accurate up to date information about the level of care required, which may lead to mistakes being made. The care plan is the working document and should provide clear guidance to the staff on how individual’s needs are to be met. The manager said that she will be reviewing the care plan format and will make sure that the plans are brought up to date and provide accurate information. Everyone is registered with a general practitioner and are supported in having access to the full range of NHS services. The input of other healthcare professionals is recorded, which shows that staff are seeking advice if they have concerns about an individual’s health. People living at the home said that they were pleased with the care and attention they received and comments included “all the staff are so kind and caring” and “ the staff look after me very well.” Staff have a good understanding of people’s care needs and preferences however this relies on informal systems of communication and is not supported by detailed, accurate and up to date care records. This creates the risk that people’s care needs may be overlooked. On reviewing the medication system I noted that there were a number of gaps on the Medication Administration Record (MAR) sheet where staff had not signed for medication. In four instances the stock control figure for PRN (as and when required) medication was wrong. Staff must be more vigilant when recording and administering medication so that people can be confident it is being given as prescribed. Parkview Rest Home DS0000001299.V346641.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home responds to individual needs and choices although more could be done to provide them with a range of appropriate social and leisure activities both within the home and the wider community. EVIDENCE: People said that they are encouraged to make as many decisions and choices as possible about their daily lives and how they want to spend their time. Feedback from people showed that there are no set times for getting up or going to bed and they generally feel that daily routines are based around their needs. The home does not employ an activities co-ordinator therefore it continues to be the responsibility of the care staff to organise activities, outings and entertainment for people. People said that generally the level of activities provided was adequate to their needs. However, questionnaires returned by two relatives expressed concern Parkview Rest Home DS0000001299.V346641.R01.S.doc Version 5.2 Page 13 that the home did not do enough to motivate people and felt this was having a detrimental affect on their general well-being. A questionnaire returned by another relative clearly indicated that they felt that the number of people living at the home with dementia was making it difficult for staff to arrange activities suitable for everyone and the more mentally alert people were missing out. The manager confirmed that it is her intention to provide people with a more stimulating environment and although only in post for a short period of time is already making plans to improve the range of social and leisure activities on offer. Several people currently attend events at the Abundant Life Church and provision can be made for people to attend their chosen place of worship if they wish to do so. One person attends a day centre. Throughout the visit staff were observed to interact well with the people in their care and people were relaxed and clearly felt comfortable in their presence. People said that they were able to see visitors in their own room if they wished to do so and family and friends were always made to feel welcome and offered light refreshment. People described the food at the home as good and recent improvements have been made to the kitchen facilities following a Food Hygiene Inspection by the Environmental Health Department, which gave the home a zero star rating. Parkview Rest Home DS0000001299.V346641.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Thorough complaint and adult protection policies and procedures make sure that individuals are listened to and protected from any form of abuse. EVIDENCE: There is a clear complaints procedure in place and people said that they would have no problems approaching the manager if they had any concerns about the standard of care being provided. The self-assessment form completed by the previous manager indicates that the home have received three complaints since the last inspection all of which have been referred to the Bradford Social Services Adult Protection Team. All three complaints were investigated and upheld. Adult protection policies and procedures are in place and information provided on the self- assessment form shows that all staff have received appropriate training in the recognition and reporting of abuse Feedback from staff indicates that they are aware of the home’s policy on “whistle blowing” and were aware of what to do if they felt any practices put in place at the home were not in the best interest of the people using the service. Parkview Rest Home DS0000001299.V346641.R01.S.doc Version 5.2 Page 15 Policies and procedures are available regarding staff involvement in the financial affairs of people living at the home, which does not allow them to become involved in the making of, or benefiting from their wills. Parkview Rest Home DS0000001299.V346641.R01.S.doc Version 5.2 Page 16 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): 19,20,21,24 and 26 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Although Park View provides a comfortable, and homely place for people to live more could be done to improve their quality of life. EVIDENCE: I looked around all areas of the home but did not go into all the bedrooms. The majority of communal areas are situated on the ground floor of the home, close to toilet facilities although there is one lounge/dining room located on the first floor. I found the standard of décor and furnishing in the communal areas to be good. Bedrooms are situated on both floors and consist of both single and double rooms. There is currently no stair lift or passenger lift to the bedrooms on the Parkview Rest Home DS0000001299.V346641.R01.S.doc Version 5.2 Page 17 first floor; therefore this accommodation is unsuitable for people with mobility problems. The standard of décor and furnishings in the rooms I looked at was generally good although some would benefit from decorating. However, I found the quality of bedding to be poor, with thin or worn sheets and stained pillows on beds. I also noted a strong smell of urine in at least two rooms, which was made worse because the commodes had not been thoroughly cleaned after use. In one double bedroom the privacy screens did not fully screen the beds and therefore people’s right to privacy was compromised. People said that they were generally pleased with their bedrooms and that they were encouraged to furnish them with personal belongings to make them more homely. Comments included “my room is nicely decorated and cleaned every day” and “my room is clean and comfortable - what more could you ask for.” The standard of décor, fixtures and fitting in all bathroom and toilets was generally good although some areas would benefit from decorating. A Lock requires fitting to the door to the ground floor bathroom to ensure privacy. I also noted that in one bathroom the lid was missing from the clinical waste bin and staff had placed soiled pads directly in the bin without wrapping them first, which is poor practice. Parkview Rest Home DS0000001299.V346641.R01.S.doc Version 5.2 Page 18 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 and 30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People that use the service are protected by the recruitment and selection procedures. There is a commitment to staff training and to ensuring that people receive the standard of care they require. EVIDENCE: The staff rota showed that sufficient care staff are employed on day and night duty to care for people and meet their needs. There is a recruitment and selection procedure in place, which includes obtaining at least two written references and a Criminal Record Bureau check before a new member of staff is employed. All staff are provided with written job descriptions, which outline their roles and responsibilities and a copy of the new staff handbook. The Area Manager confirmed that there is commitment to provide staff training and that all new staff now receive induction training using the Skills For Care Common Induction Standards. Following which there is an expectation that Parkview Rest Home DS0000001299.V346641.R01.S.doc Version 5.2 Page 19 they will achieve a National Vocational Qualification (NVQ) at level two or above depending on the post they hold. The self-assessment form shows that out of a staff team of sixteen, ten staff have achieved a NVQ at either level two or three and six staff are working towards the award. This shows a good commitment to staff training. Some training records were available and indicated that staff have attended a number of other training courses relevant to post they hold. As the staff training matrix was not available on the day of the visit the manager agreed to forward me a copy to evidence the level of training provided. Staff said that the quality of training provided is good and confirmed that the home is committed to ensuring that people benefit from having a trained, skilled and experienced workforce caring for them. Parkview Rest Home DS0000001299.V346641.R01.S.doc Version 5.2 Page 20 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): 31,32,33,35,36, and 38 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home is well managed and people are supported in making decisions and exercising choice. EVIDENCE: Mrs Julie Newton was recently appointed manager of the home following the resignation of the previous manager earlier in the year. Mrs Newton is a qualified nurse and is presently studying for the Registered Managers Award (RMA) and the NVQ assessor and verifier qualifications. Although only in post for a week at the time of inspection the manager has already identified many of the shortfalls in the service highlighted in this report and has started to review the policies and procedures in place. Staff confirmed Parkview Rest Home DS0000001299.V346641.R01.S.doc Version 5.2 Page 21 that the manager has an open and approachable management style and were looking forward to working with her. The manager confirmed that staff meetings will be held on a regular basis to keep staff up to date with any changes in policies, procedures and work practices and formal one-to-one staff supervision and appraisals are being planned. The manager is also going to review the quality assurance monitoring systems in place and is arranging meetings with people living at the home and their relatives as part of this process. Policies and procedures are available relating to the storage and processing of personal information relating to both people living at the home and staff, which comply with the Data Protection Act 1998. The home holds money in safekeeping for a number of people and transaction sheets are in place showing income, expenditure and a balance. Only senior staff deal with financial transactions and regular audits are carried out to make sure the records are accurate and in good order. Receipts are obtained for any items purchased by staff on behalf of people. Information provided in the self –assessment form also indicates that all equipment in use at the home such as hoists are serviced in line with the manufacturers guideline, so that people can be sure that they are in good working order. Parkview Rest Home DS0000001299.V346641.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 1 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 3 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 3 17 X 18 3 3 3 2 X X 2 X 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 3 3 X 3 3 X 3 Parkview Rest Home DS0000001299.V346641.R01.S.doc Version 5.2 Page 23 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 OP3 Regulation 14 Requirement A full assessment must be carried out before people are admitted to the home to make sure that staff are able to meet their needs. Timescale for action 30/11/07 2. OP7 15 Care plans must contain accurate 09/12/07 and up to date information about people so that staff can provide the level of care they need. An accurate stock control system must be maintained for medication administered on a PRN (as and when required) basis and all medication must be signed for on the Medication Administration record (MAR) sheet, so that people can be confident that medication is being given as prescribed. A lock must be fitted to the bathroom door on the ground floor so that people’s right to privacy respected. 30/11/07 3. OP9 13(2) 4. OP21 23 30/11/07 Parkview Rest Home DS0000001299.V346641.R01.S.doc Version 5.2 Page 24 5. OP24 23 Appropriate screens must be provided in all double bedrooms so that people’s right to privacy is not compromised. Old and worn bedding and pillows must be replaced so that people are able to sleep in comfort. The odour problems noted in the bedrooms must be eliminated so that people can sleep in a pleasant environment. Soiled incontinence pads must be wrapped before they are placed in the clinical waste bags for disposal so that people are protected from possible cross infection. 30/11/07 6. OP26 23 30/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Parkview Rest Home DS0000001299.V346641.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Rest Home DS0000001299.V346641.R01.S.doc Version 5.2 Page 26 - 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. 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