Inspection on 27/10/05 for Parkview Rest Home

This inspection was carried out on 27th October 2005.

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 Rest Home 22/09/09

Parkview Rest Home 23/09/08

Parkview Rest Home 19/10/07

Parkview Rest Home 12/06/06

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 Susan Knox Unannounced Inspection 27th October 2005 09:15 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.V258844.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 Rest Home DS0000001299.V258844.R01.S.doc Version 5.0 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 Leonnard Crabtree 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.V258844.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2 September 2005 Brief Description of the Service: Park View is a detached adapted building that provides accommodation for twenty three residents 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 alongwith a small car park. Well kept gardens are to the front of the home where service users can sit and enjoy the good weather. Parkview Rest Home DS0000001299.V258844.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by two inspectors in one day. It started at 9.15 am and finished at 4.00 pm. The operation manager for the four homes owned by the providers Mrs Denise Smith arrived shortly after the inspection started. The acting manager for Park View Mrs Ann Leyland arrived later. This inspection is part of a number of monitoring visits carried out by the CSCI to check that the providers are making changes in the home because of failures to meet minimum care standards. There have been improvements but some personal care tasks could be better. There is still some uncertainty about a registered manger that needs to be resolved in order for the home to move forward. Mrs Smith was informed in feedback at the end of the visit that monitoring visits would continue. Most of the day was spent in talking to service users and staff about the standards of care and support at the home. A number of documents including care plans were inspected. Feedback on the findings from the inspection was given to Mrs Smith and Mrs Leyland. What the service does well: What has improved since the last inspection? Care planning continues to improve. Accidents are monitored monthly. Parkview Rest Home DS0000001299.V258844.R01.S.doc Version 5.0 Page 6 The numbers of training courses attended and booked for care staff has improved. 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 Rest Home DS0000001299.V258844.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 Rest Home DS0000001299.V258844.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): None EVIDENCE: None of the above standards were inspected. Parkview Rest Home DS0000001299.V258844.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, 9, 10. Care planning continues to improve but information in them varies. The carer’s knowledge of individual needs must be formalised in care planning. Where risk assessments identify a concern this must be followed up in a care plan that helps staff to minimise the risk. Health care professionals were contacted for help and advice. Staff must be more vigilant when providing personal care for those who need help in order to maintain dignity and respect for service users. EVIDENCE: Four sets of care documentation were checked. Care plans have improved the format is good and some gave good detail. They now contain more information about residents’ needs although some elements gave good information others were general. All care plans need more information about the resident and should be reorganised to ensure the information is accessible. Staff were able to explain how individual resident’s needs were met, many of the needs described were not included in the care plans. Parkview Rest Home DS0000001299.V258844.R01.S.doc Version 5.0 Page 10 Several risk assessments had been completed for each resident such as moving handling. For one a nutritional screening chart had been completed that identified the service user was at risk. A care plan should have been made to show what needed to be done about this. Each care plan had a monthly update record. However, the updates were not effective as the same or similar information was recorded each month. For example, ‘talking to staff more’ had been entered for three consecutive months but the resident had not made this progress for three months. One update identified that a medication issue needed following up but there was no evidence this had been done. Monthly evaluations were carried out as required. Discussions were held about identifying changes in this record rather than monthly updates. In the care plans checked there was no evidence of service user or relative involvement. The operations manager said this work had started with relatives invited to attend reviews. Staff discussed the arrangements for health care and said regular contact is maintained with GPs and District Nurses. Records confirmed that an optician and chiropodist had recently visited the home. The inspectors noted that some service users looked unkempt. One was in an inappropriate dress and a bed jacket; another had difficulties with shoes because the laces were not long enough. Several had food spillage on their clothes these had not been changed even though other care tasks had been carried out by staff. The home administers medication via a monitored dosage system MDS. A random count of two types of medication was satisfactory. The records for administering medication were satisfactory. The senior carer was aware of her responsibilities and able to answer any queries. Topical medication that requires cold storage must be kept in a fridge. Parkview Rest Home DS0000001299.V258844.R01.S.doc Version 5.0 Page 11 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, 14, 15. Service users are enabled to follow own pursuits if this is their preference and there is an understanding that this can be a risk. The previous concerns about the menu have been addressed and a varied diet is provided. EVIDENCE: Staff are now given the responsibility of arranging activities each afternoon. They said this works well. Although a small number of service users prefer to remain in their rooms following their own pursuits. One does leave the home independently. The menus have been reviewed since the last inspection. Staff said the ‘new menus are very good and food is varied’. Records showed that menus were generally being followed and any variations were recorded. Service users who were able to express a view said they were happy living at Parkview. Several also said the staff were nice. Discussions were held about enabling independence such as making a hot drink, while at the same time remaining aware of the risks involved. Parkview Rest Home DS0000001299.V258844.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, 18 Management are working hard to improve the care given but there still areas of concern. Management are fully aware of adult protection procedures. In order to fully protect service users staff must report and record unexplained bruising. EVIDENCE: The complaint procedure is displayed publicly in the hallway for all visitors to see. Monitoring visits by the CSCI have been carried out at Park View because of complaints made earlier in the year about the poor quality of personal care given to service users. The providers and operations manager are working with the CSCI to overcome the problems. The operations manager said that there have no further complaints received by the home. Although inspectors have seen an improvement, personal care tasks were still observed to be a concern during this inspection. For one this was about the appropriateness of the clothing worn. Discussed with management was the need for care staff to be more vigilant in their observations of clothing. The operations manager is aware of the local Adult Protection procedures. She was advised to contact this unit for advice about one issue. It was observed during the inspection that one service user had some bruising but this was not recorded in care notes or the reasons how this had happened. Managers said this due to the habits of the service user when moving around Parkview Rest Home DS0000001299.V258844.R01.S.doc Version 5.0 Page 13 the home. Management were reminded that records are required to be kept of service users who sustain bruises even when accidental. Parkview Rest Home DS0000001299.V258844.R01.S.doc Version 5.0 Page 14 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): 25, 26 In order to improve the environment the malodour from the small lounge WC must be checked and rectified. The drying of clothes on radiators in communal areas spoils the environment and increases staff workloads taking time away from service users. This could be overcome with the purchase of a dryer. EVIDENCE: A full inspection of the building was not carried out. During the inspection the inspectors worked from the smallest lounge, to the rear of the building. It was apparent that the WC accessed from this room had a major problem with malodour. This needed checking as it appeared to be caused by more than just spillage. It was noted that laundry was being dried on radiators in communal areas. No separate driers are provided in the laundry. Due to the bad weather recently this has created a backlog of laundry to be dried. Lack of laundry facilities Parkview Rest Home DS0000001299.V258844.R01.S.doc Version 5.0 Page 15 creates a number of problems in bad weather for example, more staff time in finding places to dry clothes, slow return of clothes to service users and moisture of drying clothes causing décor damage. Effective laundry facilities must be provided. Parkview Rest Home DS0000001299.V258844.R01.S.doc Version 5.0 Page 16 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, 29, 30. Moving staff from one home to another does affect the service provided to residents. This also affects the effectiveness of daily allocations. Recruitment procedures are on the whole good and ensure the protection of vulnerable people. This is let down by the failure to obtain the required two references for one carer. These records must be available in the home the staff are working in. The induction of new staff must improve so that capable staff can provide care. Qualified staff must provide moving and handling training in order to protect the service users. EVIDENCE: On arrival at the home staffing levels were low for the first hours of the morning shift. This was because the provider’s second home nearby had requested help due to last minute sickness. It is acknowledged that this is common practice in groups of homes but this can lead to problems. In this instance at Parkview the home was left with one senior care and two carers for a very busy period of time that included the provision of breakfasts. The third carer returned later and also the acting manager. Staff are allocated specific duties when they start each shift. This system works well and staff have a clearer understanding of their responsibilities. Parkview Rest Home DS0000001299.V258844.R01.S.doc Version 5.0 Page 17 Recruitment files were checked for the latest recruits. One started work in February and the other September of this year. One had moved from the provider’s other home and recruitment files had to obtained from there. CRB and POVA first checks were available and showed that good recruitment practices had been carried out to ensure the staff were fit before starting work. This is an improvement since the last inspection. One had two references as required. The second had one only. This is not good practice and the second reference must be followed up. A staff member who recently started work confirmed that she had attended an interview and had to wait until she had received a criminal records check before she could start work. This is as required. A TOPPS induction form was available for one carer but had not been completed. Although the manager said that an induction had been given this was recorded on other documentation and was not available. The member of staff transferred had not had an induction at Park View. New employees should complete a planned induction. There is an induction checklist sheet but there is no clear guidance on what the induction should involve. This has resulted in informal inductions with no clear direction. Recruitment records should be in the home where staff are working. In addition staff require to be inducted in the home that they are working in. If staff move between homes then the procedures need amending to ensure that staff records are transferred to current place of work. Two staff had recently completed emergency first aid training. Some staff had received in-house moving and handling (M & H) training. The operations manager said she has completed a training course that qualifies her to facilitate M & H training. She agreed to forward her certificate to the commission. The acting manager has conducted some M & H but this must cease, as she is not qualified. There was evidence that some M & H training was unsatisfactory. Parkview Rest Home DS0000001299.V258844.R01.S.doc Version 5.0 Page 18 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, 35, 38. Injuries to residents must be recorded to ensure their health and welfare can be properly monitored. Financial systems have improved but all monies held on behalf of residents must be accounted for to ensure their finances are properly safeguarded. Regular fire equipment testing is carried out but staff have not had an opportunity to practice what action to take in the event of a fire, this could put residents at risk. EVIDENCE: Care staff said the area manager was very approachable and she encouraged everyone to make suggestions for improvement and discuss concerns. The area manager has introduced more detailed financial recording systems for monies that are handled on behalf of residents. Each transaction is recorded. Parkview Rest Home DS0000001299.V258844.R01.S.doc Version 5.0 Page 19 However, purchases made on behalf of one resident are not properly recorded and receipts are not obtained. The area manager must make sure proper accounting records are maintained for all monies held on behalf of residents. Fire records confirmed that weekly fire and emergency lighting tests are carried out. According to the records only two staff working at the home have attended a fire drill. The acting manager said a drill had been held the previous week but this had not been recorded. Staff spoken to at the inspection had not attended a drill at the home. Fire drills must be arranged for all staff to attend and records kept including the names of those staff attending. Accident reporting was checked and found to be satisfactory apart from the non-reporting of bruising as referred to earlier in the report. The operations manager carries out monthly monitoring of accidents. This is good practice and identified a risk with service users able to access the kitchen. The manager had carried out a risk assessment but discussions were held about other vulnerable service users. The manager was advised to discuss this at a staff meeting and act accordingly. Parkview Rest Home DS0000001299.V258844.R01.S.doc Version 5.0 Page 20 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 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 1 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 x x x x x x 2 2 STAFFING Standard No Score 27 2 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 2 x 2 x x 2 Parkview Rest Home DS0000001299.V258844.R01.S.doc Version 5.0 Page 21 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 OP7 Regulation 15 Requirement The providers must ensure further detail is required in care planning. Where risk is established a care plan is required in order to minimise the risk. The providers must ensure that topical medication requiring cold storage is kept in a fridge. The providers must ensure that staff are more vigilant in carrying out personal care tasks. The providers must ensure that unexplained bruising is reported and recorded. The providers to ensure the cause of the malodour from the WC is identified and eradicated. The providers to ensure that effective drying equipment is provided. The providers must ensure that two references are obtained before employing staff. Follow up the outstanding reference. The providers must ensure that effective induction takes place for new staff. Qualified staff must carry out training. DS0000001299.V258844.R01.S.doc Timescale for action 01/12/05 2 3 4 5 6 7 OP9 OP10 OP18 OP26 OP26 OP29 13 12 12 13 16 18 01/12/05 01/12/05 01/12/05 01/12/05 01/12/05 01/12/05 8 OP30 18 01/12/05 Parkview Rest Home Version 5.0 Page 22 9 10 OP35 OP38 13 13 The providers must ensure that receipts are kept of transactions taking place. The providers must ensure that all staff attend a fire drill at least twice a year. This must be recorded. 01/12/05 01/12/05 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 2 Refer to Standard 18 27 Good Practice Recommendations Contact the Adult Protection unit about the issue discussed. Ensure that the movement of staff from one home to another does not affect the routines and service in the first home. Parkview Rest Home DS0000001299.V258844.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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. Extracts may not be used or reproduced without the express permission of CSCI Parkview Rest Home DS0000001299.V258844.R01.S.doc Version 5.0 Page 24 - 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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