Inspection on 07/12/05 for Parkwood House

This inspection was carried out on 7th December 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Parkwood House 04/04/07

Parkwood House 02/08/06

Parkwood House 16/06/05

Parkwood House 17/01/05

Parkwood House 30/07/04

Parkwood House 11/02/04

Similar services:

Hunters Care Centre

Manor Lodge

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

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

CARE HOMES FOR OLDER PEOPLE Parkwood House 72/74 Exmouth Road Stoke Plymouth Devon PL1 4QJ Lead Inspector Fiona Cartlidge Unannounced Inspection 7th December 2005 11:00 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 Parkwood House DS0000044973.V262055.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. Parkwood House DS0000044973.V262055.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Parkwood House Address 72/74 Exmouth Road Stoke Plymouth Devon PL1 4QJ 01752 560000 01752 609670 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) Southern Healthcare (Wessex) Ltd Mrs Belinda Victoria Woodward Care Home 48 Category(ies) of Dementia - over 65 years of age (14), Old age, registration, with number not falling within any other category (14), of places Physical disability (38), Physical disability over 65 years of age (38), Terminally ill (4) Parkwood House DS0000044973.V262055.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home is registered as a Care Home with Nursing for a maximum of 48 Service Users in the categories of PD 38, PD(E) 38, OP 14, DE(E) 14, TI 4 16th June 2005 Date of last inspection Brief Description of the Service: Parkwood House is a 48 bedded care home situated in the Stoke area of Plymouth close to local amenities. The home is able to accommodate Service Users of either gender over the age of 50.The home is registered for a variety of categories including residential care for people with dementia and general nursing care. The home is arranged on 4 floors with 10 double rooms, 4 of which are en-suite and 26 single rooms 6 of which are en-suite. There is level access to all parts of the building via shaft lifts, stair-lifts and ramps There is a small garden to the rear. The manager is a registered general nurse who heads up a team of trained nurses and carers, there are appropriate ancillary staff to support the services provided. Parkwood House DS0000044973.V262055.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 4 hours and 45 minutes and was unannounced. This was the homes second statutory inspection of the year 2005-2006 readers may wish to consider the content of both reports to gain a full picture of the homes achievements. A partial tour of the home took place when some bedrooms and all communal areas were viewed. Individual records of care held on behalf of 2 residents and some of the homes policies and procedures were inspected. The inspector spent the majority of the time talking with 15 residents, 3 visitors, 3 staff members the registered manager, and took time observing actual practise. What the service does well: What has improved since the last inspection? There were no fire doors being wedged open during this inspection. One bedroom with an en-suite WC has been fitted with a new door to the Ensuite and new toilet seat. The documentation of care plans continues to improve; changes in need had been reflected to assist staff in providing continuity in the residents care. Parkwood House DS0000044973.V262055.R01.S.doc Version 5.0 Page 6 The homes policy and procedures for responding to allegations of abuse or neglect have been reviewed and updated to include external agencies to be contacted. There was less evidence of soap bars being used in communal bathrooms and shared by residents. Liquid soap and disposable towels were seen to be readily available for use by staff as were disposable gloves if needed. 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. Parkwood House DS0000044973.V262055.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 Parkwood House DS0000044973.V262055.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): 2,3,5 The admission process is safe. People are invited to visit the home before making a decision about admission. Some information in the contract provided by the registered provider is dated and could cause confusion. EVIDENCE: The inspector examined personal care records held on behalf of 2 recently admitted residents; all included pre-admission information supplied from care management or hospital settings. Information about health, personal and social care had been sought and most residents are visited in their current settings to enable the registered nurses to make a professional judgement about how needs will be met before offering the individual the opportunity of admission. Residents told the inspector that the home had been recommended to them through word of mouth or that relatives had chosen it after viewing several in the area. All of those spoken to said they were pleased that they had moved to Parkwood one resident told the inspector ‘there’s no place like home, but its a very good second best’. Parkwood House DS0000044973.V262055.R01.S.doc Version 5.0 Page 9 The inspector looked at a contract (terms and conditions of residency) this included information about services and facilities included in the fee as well as extras to be paid for over and above the fee and periods of notice. The contracts where out of date quoting legislation, which has been superseded and does not provide a clear breakdown of how much the fee is and who is responsible for which part of the fee e.g. resident, local or health authority, relative or another. A requirement was made following the last inspection for these documents to be updated a further requirement has been placed in this report. Parkwood House DS0000044973.V262055.R01.S.doc Version 5.0 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 The health care needs of residents are met. The Care plans are reviewed and updated to reflect changes in need, this assists staff to be consistent in their approach to changes in peoples needs. The lack of records for medication no longer in use, may pose a risk that some medication could be misused. EVIDENCE: The home provides a comprehensive care planning process for residents based on information received before and on admission as well as continual assessment of their needs. The care plans viewed during the inspection were fully completed and appropriately reviewed. All the residents spoken to said that they feel well cared for, are treated well by the staff and that their privacy is respected. Documentation provided evidence that General Practitioners, chiropodists, dentist and physiotherapists visit residents and that they are referred to specialist community and hospital health specialists when necessary. Records of outpatient appointments show that visits to community and hospital health resources are enabled. Parkwood House DS0000044973.V262055.R01.S.doc Version 5.0 Page 11 Residents told the inspector that the staff respect their privacy and dignity, the inspector observed that when personal care was being provided this was done behind closed doors, the staff spoke to residents in a polite and cheerful manner and knocked on the doors to private accommodation before entering. The inspector examined the system of medication management; Records of all medication entering the home and being administered are kept. Where medication was written as 1 or 2 tablets to be given, there was clear indication of how many had actually been administered. Medication no longer in use had been placed in the correct bin for disposal by a licensed waste contractor; this bin was not being stored in a locked cupboard, however it was in a locked room, which is accessed only by nursing staff. There were no records made at the time of the medication being placed in the bin - best practise indicates a registered nurse and witness should record the actual date the medicine was added for disposal, with the name and strength of the medication, quantity, name of resident for whom the medication was prescribed, signature of the member of staff and witness and on removal by the contractor, date and signature of consignment of the waste to the contractor. Parkwood House DS0000044973.V262055.R01.S.doc Version 5.0 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): 12,13,15 Social activities are organised and provide stimulation and interest for residents on most days. Meals are nutritious and balanced offering a healthy and varied diet for residents. Visiting arrangements are good. EVIDENCE: Following admission to the home, the staff record details of each residents social history which includes past occupations, experiences, hobbies and interests this information aids the staff to put an individual social care plan in place, one of the records seen showed that a resident continued to have regular contact with the local salvation army group another attends a day centre on a weekly basis. Some residents were seen socialising in the lounge or watching television others were spending time in their rooms, reading or listening to music and two residents remained in the dining area assisting with some domestic type duties, both said they had volunteered and felt they were helping by releasing the staff to do more important tasks. The activities programme is updated monthly and was found displayed in the entrance hall, activities in December include bingo, movies, arts and craft sessions, visits from the hairdresser and clergy, a Christmas party to include Parkwood House DS0000044973.V262055.R01.S.doc Version 5.0 Page 13 buffet and musical entertainment and a day trip to Cornwall. Residents told the inspector that they appreciated and enjoyed the level of organised activity. Some residents said they were aware that activities were organised but didn’t want to attend and so were not made to, one resident said they got stimulation from being able to visit the local pub regularly. The feedback about food was positive all of the residents spoken to said how good it was; A menu was displayed in the entrance hall advertising that alternatives to the set menu are available on request. Records seen provided evidence that resident’s weights are regularly monitored. The people living in the home told the inspector they were happy with the visiting arrangements, visitors said they feel welcomed into the home and are able to visit their relative/friend in private and have meals if they like. Parkwood House DS0000044973.V262055.R01.S.doc Version 5.0 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 People are safe living in this home and know who to speak to if they are dissatisfied. EVIDENCE: The home has a comprehensive complaints procedure. This was available to residents in the ‘useful’ Guide found in their private accommodation and displayed in the reception hall of the home. Those residents’, who were asked, said that they knew who to complain to if they had any concerns and felt confident that these would be dealt with in a sensitive way by the staff. Policies and procedures for the protection of residents and staff are in place and they include information about agencies that should be contacted if allegations of negligence or abuse are made. Members of staff are given a work - book with information on how to recognise and respond to abuse as well as a whistle blowing policy. All of the residents spoken to confirmed they feel safe living in the home. One resident said if they had any problems they tell matron and she sorts it out. Parkwood House DS0000044973.V262055.R01.S.doc Version 5.0 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): 19,20,23,24,25,26 The home is well decorated and furnished and clean, pleasant and hygienic. EVIDENCE: Parkwood House DS0000044973.V262055.R01.S.doc Version 5.0 Page 16 A tour of the home confirmed that rooms have a wardrobe, bedside and overhead lighting, an appropriate bed (some are adjustable), a set of drawers, seating, over-bed table and a wash hand basin and are pleasantly decorated in a ‘homely’ fashion. The doors to individual accommodation are not fitted with locks, a child proof gate was seen in a corridor and when the inspector asked why it was there was told by a member of the staff that a resident wanders into other residents rooms and it upsets them so they close the gate to prevent it, this practise of restraint is unacceptable. A requirement to fit suitable locks to residents rooms has been made to ensure residents feel safe and secure, but that can also be accessed easily by staff in an emergency. Limited storage areas are available for wheelchairs and other equipment some wheelchairs were found stored in a residents bedroom. A nurse call bell system is in place throughout the home. Rooms within the home are individually and naturally ventilated. The home has central heating throughout; each radiator can be controlled separately. Not all of the radiators are covered or have guaranteed low surface temperature these have signs above them warning people not to touch them - a requirement has been made for all radiators that residents may have contact with to be risk assessed and covered if indicated. Lighting in Service Users accommodation is suitable and the home has emergency lighting throughout. The home was clean and most areas were odour free at the time of the inspection. Parkwood House DS0000044973.V262055.R01.S.doc Version 5.0 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 There are not always enough staff on duty to meet the needs of some residents. The staff team are kind and motivated. EVIDENCE: As already stated in the environmental standard a child proof gate was seen in place to prevent a wandering resident from entering other residents rooms, in addition to this poor practise the inspector witnessed a resident being held in their arm chair by a lap strap the inspector was told by the manager that this was only used when the lounge the resident was sat in had no staff in attendance. The inspector explained why this practise of restraint is unacceptable and explained that it indicated that more staff should be available or better deployed to meet the needs of residents who wander and or are at risk of falls. Some good practises were observed such as the use of pressure pads to alert staff when residents get up from their chairs or out of bed at night and the use of hip protection underwear for those at risk of falls. Where forms of restraint are used a requirement has been made that this is only done following multi-disciplinary agreement where all other avenues of management of the individuals need have been exhausted and that the care plan clearly states why and when and how often the restraint is used and provides a regular opportunity of release at least twice hourly this must be documented and performed. Parkwood House DS0000044973.V262055.R01.S.doc Version 5.0 Page 18 A staff training matrix was seen displayed in the office and staff spoken to said that they received regular training and updates to ensure they have the skills and knowledge to safely care for the residents in the home. The manager told the inspector that staff personnel files are currently held at the companies head office in Exeter so these were not seen on this occasion. The home employs a number of over seas staff and if/when a communication problem is identified English language lessons have been arranged. All of the residents spoke highly of the staff saying they were kind and worked hard to meet their needs. One resident said ‘ all of the staff are as good as gold’. Parkwood House DS0000044973.V262055.R01.S.doc Version 5.0 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): 31,32,33,37,38 The home is being managed properly and there is evidence of clear leadership, guidance and direction to staff. EVIDENCE: Residents, visitors and staff made positive comments about the manager in the home saying they felt comfortable approaching her with issues. Residents also told the inspector that the registered provider visits on a weekly basis and shows an interest in how their needs are being met. Communication systems are regular through staff handovers, and formal meetings are held, the inspector was told of a meeting held the week before the inspection with relatives/residents representatives. A relative told the inspector that they are kept well informed about any changes in their relative’s condition. The provider demonstrated a responsible attitude towards health and safety – The inspector examined the fire safety manual, which indicates that the Parkwood House DS0000044973.V262055.R01.S.doc Version 5.0 Page 20 maintenance person regularly tests the fire safety equipment and system and that this is also serviced annually by a suitably qualified contractor. A current certificate of employers liability insurance was seen displayed in the entrance hall as was a certificate providing evidence that a recognised quality assurances system is in place as the home achieved the investors in people award, this was dated November 2005. A resident told the inspector that they had received a questionnaire from the home asking if they were happy here? The resident told the inspector that of course they would have been happier if they could have managed in their own home but as far as living in residential care they didn’t think they could be happier than they are at Parkwood. Risks to residents are individually assessed and documented with an agreed documented plan in place to minimise risk where possible. All of the records seen during the inspection were clear, well maintained and secure. Parkwood House DS0000044973.V262055.R01.S.doc Version 5.0 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 X 2 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X 2 2 3 STAFFING Standard No Score 27 2 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X 3 3 Parkwood House DS0000044973.V262055.R01.S.doc Version 5.0 Page 22 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 OP2 Regulation 5b Requirement The contract (terms and conditions of residency) must be updated in accordance with the Care Standards Act 2005 and should clearly indicate the amount and whom is responsible for payment of each part or all of the fee.Extended from 01/09/05 To ensure the privacy dignity and security of service users, doors to service users’ private accommodation should be fitted with locks suited to their capabilities and accessible to staff in emergencies. Each service user must be provided with lockable storage space for medication, money and valuables and be provided with a key(unless the reason for not doing so is explained in the care plan) Risk assessment must be performed/reviewed on all radiators, where a risk is identified design solutions must be put into place to reduce the risk of scalds/burns to service users. DS0000044973.V262055.R01.S.doc Timescale for action 01/02/06 2. OP24 16(2) 01/04/06 3. OP25 13 01/01/06 Parkwood House Version 5.0 Page 23 4 OP27 13(7)(8) Service users must not be subject to restraint because of shortage of staff to meet their needs. Staffing levels must be based on the assessed needs of the residents. 01/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations Records should be made at the time of the medication for destruction being placed in the bin - best practise indicates a registered nurse and witness should record the actual date the medicine was added for disposal, with the name and strength of the medication, quantity, name of resident for whom the medication was prescribed, signature of the member of staff and witness and on removal by the contractor, date and signature of consignment of the waste to the contractor. Parkwood House DS0000044973.V262055.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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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