Inspection on 15/06/05 for Preston Private Nursing Home

This inspection was carried out on 15th June 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 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

Preston Private Nursing Home 11/12/08

Preston Private Nursing Home 29/05/08

Preston Private Nursing Home 24/07/07

Preston Private Nursing Home 20/09/06

Preston Private Nursing Home 20/02/06

Preston Private Nursing Home 13/01/05

Preston Private Nursing Home 12/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Preston Private Nursing Home Midgery Lane Fulwood Preston Lancashire PR2 5SX Lead Inspector Lynne Lynch Unannounced 09 and 15 June 2005 9:30am 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 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. Preston Private Nursing Home F57 F09 S6073 Preston Private V189509 090605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Preston Private Nursing Home Address Midgery Lane, Fulwood, Preston, Lancashire, PR2 5SX Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01772 796801 Parkcare Homes (no. 2) Limited Edward Poland Care Home 106 Category(ies) of DE Dementia 33, OP Old Age 55, PD Physical registration, with number Disability 18 of places Preston Private Nursing Home F57 F09 S6073 Preston Private V189509 090605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may accommodate up to a maximum of 73 older people when not using those places designated for persons with a physical disability. 2. The total number of persons accommodated in the home at any one time shall not exceed 106.3. The home must not accommodate any service user under the age of 40 years. Date of last inspection 13th January 2005 Brief Description of the Service: Preston Private Nursing Home is owned by Parkcare Homes, and is registered with the Commission for Social Care Inspection to accommodate 106 service users, male or female, with general medical needs, aged 40 years and over, and for those with dementia aged 50 years and over. The home is a purpose built single storey building and care is provided in four units, each with its own lounge/dining facilities and own kitchen area. There are ninety single bedrooms of which 23 have en-suite facilities, and eight double rooms of which one has an en-suite facility. The home is set in its own grounds and has extensive well maintained gardens and a parking area. Preston Private Nursing Home is located in a rural area of Fulwood, Preston and is relatively close to shops and local amenities. It is situated on a bus route into Preston town centre. Service users are encouraged to maintain their links in the community, and every effort is given to ensuring that relationships, hobbies and interests are pursued. Activities are organised by the diversional therapists and in-house entertainment and outings are organised for those service users who wish to participate. Relatives, friends and visitors are made welcome at the home. The home has small kitchen areas for the use of service users and visitors. Preston Private Nursing Home F57 F09 S6073 Preston Private V189509 090605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and started at 9.30 a.m. It took place over two days and was carried out by two inspectors. The inspectors spoke to ten residents, six relatives, a district nurse, nine members of staff and the manager. Part of the inspection was spent on looking at care documentation together with the homes policies and procedures. Staff files and training records were also viewed. Records in respect of safe working practices were also examined. A partial tour of the building was also carried out. At the time of the inspection there were 85 residents Comment cards were distributed prior to and during the inspection three residents and seven relative comment cards were received back. The lead inspector following the inspection also received a telephone call from a relative. What the service does well: What has improved since the last inspection? The home has addressed the Health and Safety issues highlighted during the previous inspection and have recently undergone a recent Health and Safety check carried out by an external agency for which they received favourable feedback. A new thorough induction and foundation training format has been introduced for new staff in the home and is to be extended to all staff in time. Preston Private Nursing Home F57 F09 S6073 Preston Private V189509 090605 Stage 4.doc Version 1.40 Page 6 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. Preston Private Nursing Home F57 F09 S6073 Preston Private V189509 090605 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Preston Private Nursing Home F57 F09 S6073 Preston Private V189509 090605 Stage 4.doc Version 1.40 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 standard(s) 3 and 6 Prior to moving into the home, a full comprehensive assessment takes place, which insures that needs can be met. EVIDENCE: The admission procedure is very thorough and provides a good guide for staff on the actions to be taken to ensure that new residents needs are properly addressed and planned. Documentation was examined for nine residents in each case the assessment paperwork including nutritional information, skin viability and handling assessments were on file. Minor omissions on some of the standard forms were noted. Most of the files also contained additional social care assessments and specialist input in relation to specific health needs. The residents and relatives spoken to confirmed that the manager or senior staff had made visits to ascertain need. Additional risk assessments are also carried out. People are not admitted to Preston Private solely for intermediate care. Preston Private Nursing Home F57 F09 S6073 Preston Private V189509 090605 Stage 4.doc Version 1.40 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 standard(s) 7 and 8 Each care plan is regularly reviewed, which ensures that changing needs are responded to. Promotion of health is taken seriously. Resident’s welfare is closely monitored and health needs are met. EVIDENCE: A care plan for each resident was in place and was reflective of needs these were generally reviewed on a monthly basis. The care plans take into account the health, personal and social care needs of each resident. The home has introduced a new care plan for use on the Dementia unit, which provides sections for additional mental health information. The care plans in general were completed fairly well, however some omissions were noted on paperwork e.g. residents name being omitted, which could mean separate sheets go astray. Care plans were reviewed on a monthly basis with changes being made reflective of need. However corresponding risk assessments did not all appear to have been reviewed. In one ladies case this was prevalent due to her having Preston Private Nursing Home F57 F09 S6073 Preston Private V189509 090605 Stage 4.doc Version 1.40 Page 10 a fall and her needs changing notes in this case were however made on the care plan. It was felt that the care files lacked uniformity and needed some housekeeping with information being sectioned off to enable easier access for all. Daily records show that health care is monitored and good contact with health professionals is maintained. Residents and relatives stated that staff are very good during times of ill health and relatives of a resident who was terminally ill said that they were impressed with the professionalism of staff and the way they had communicated with other external specialist medical staff to ensure the best care for their relative “they are caring with a capital C”. Physiotherapy input was noted the file of one lady to prevent further rapid deterioration of her condition. One lady spoken to said she had had two operations since moving into the home and felt she was very well cared for during her recovery. All residents spoken to said they felt they could access medical services when they needed them. The three residents comment cards received stated they felt well cared for. The home cares for residents with many complex health needs and make every effort to ensure specialist equipment is obtained and that staff have the skills and knowledge to meet the changing needs. Preston Private Nursing Home F57 F09 S6073 Preston Private V189509 090605 Stage 4.doc Version 1.40 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 standard(s) None of the above standards were inspected at this visit. EVIDENCE: Preston Private Nursing Home F57 F09 S6073 Preston Private V189509 090605 Stage 4.doc Version 1.40 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 standard(s) None of the above standards were inspected at this visit. EVIDENCE: Preston Private Nursing Home F57 F09 S6073 Preston Private V189509 090605 Stage 4.doc Version 1.40 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 standard(s) None of the above standards were inspected at this visit. EVIDENCE: Preston Private Nursing Home F57 F09 S6073 Preston Private V189509 090605 Stage 4.doc Version 1.40 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 and 30 Staffing levels are satisfactory to meet the needs of the residents. The policies and procedures for the recruitment of staff are robust and provide safeguards for the protection of residents. Sufficient training is in place to ensure staff development. EVIDENCE: At the time of the inspection the staffing list indicated that the home had 76 employees. Staffing levels were satisfactory and there was a good mix of qualified and care staff to meet the needs of the residents with 19 staff working on the floor to care for 85 residents. Staff spoken to said that whilst they were busy there was always enough staff on duty to spend time with residents and were continually observed doling so during the day. Residents and visitors spoken to said that, the staff are friendly and helpful and even though busy did respond to call bells being activated. The inspector observed staff working with residents and was satisfied that all tasks were carried out in a pleasant and courteous way. Seven relatives completed feedback comment cards only one of these felt that staffing wasn’t adequate in the home. There has been some staff turnover of staff in the last 12 months, which is to be expected with a home of this size. Recruitment processes are now centralised and carried out at the company’s head office. The staff files viewed indicated that all the necessary recruitment checks to ensure protection of the residents had been carried out, however clarification of English Criminal Record Preston Private Nursing Home F57 F09 S6073 Preston Private V189509 090605 Stage 4.doc Version 1.40 Page 15 Checks is required on files of oversees members of staff in addition ones from their country of origin. The manager was requested to clarify this with their head office. The home has now introduced a new induction and foundation training system. Areas of competence are set out in workbooks the training is linked to Topps standards and is very thorough and is planned to be extended to existing staff in the near future. The home now has 33 of staff NVQ qualified. Training issues were noted to be highlighted during staff appraisal sessions. Staff spoken to said that the home has a rolling programme of training which is accessible to all staff one staff spoken to confirmed that she had recently attended two mandatory training sessions. The home requires a training matrix that would reflect it’s current position with training at any given time to ensure staff are not omitted from mandatory training. Following some concerns raised in respect of communication sometimes being a difficulty in the home the inspectors addressed the current employment of oversees staff with the manager. The manager agreed this was a concern however the company had arranged Basic English courses for employees. One staff file viewed confirmed that a member of staff was being held back a little with her development due to poor English, however residents and relatives spoken to did not seem to have great difficulty in this area one relative said “you just have to listen more carefully and speak slower it is not a problem”. Preston Private Nursing Home F57 F09 S6073 Preston Private V189509 090605 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 38 The management and staff at the home are competent and the health, safety and welfare of residents is strongly promoted. EVIDENCE: People living at the home made positive comments about the manager and staff being available, approachable and willing to listen to their opinions. Quality monitoring systems include internal systems, which invite feedback from people living at Preston Private and their relatives and the achievement and maintenance of the Investors in People award. The company has it’s own governance dept which carries out regular audits focusing on different aspects of the service and preparing reports for the manager to act on. The manager follows up any issues raised on the feedback questionnaires sent to relatives. Preston Private Nursing Home F57 F09 S6073 Preston Private V189509 090605 Stage 4.doc Version 1.40 Page 17 Inspection of records indicated that that regular fire drills take place and that fire equipment is regularly serviced. Information provided in the questionnaire completed by the manager stated that all safety equipment is regularly serviced. Accident and incident, pressure sores and medication statistics are collated on a monthly basis by a senior member of staff and forwarded to the company’s head office. The home had recently had a Health and Safety audit carried out by an external agency and received positive feedback from the visit. The three service users who completed feedback comment cards said they felt well cared for and safe at the home. Preston Private Nursing Home F57 F09 S6073 Preston Private V189509 090605 Stage 4.doc Version 1.40 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 3 x x x x 3 Preston Private Nursing Home F57 F09 S6073 Preston Private V189509 090605 Stage 4.doc Version 1.40 Page 19 no Are there any outstanding requirements from the last inspection? 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 Regulation Requirement Timescale for action 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. 3. Refer to Standard OP7 OP30 OP29 Good Practice Recommendations Residents care plans should be reconstructed to make them simpler and easier to follow by all staff. A training matrix should be in place to ensure all staff remain trained in mandatory areas and that training can be tracked at all times. The manager should confirm that English Criminal Records Bureau clearance has been obtained for all overseas staff and this should be documented in staff files. Preston Private Nursing Home F57 F09 S6073 Preston Private V189509 090605 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Unit 1, Tustin Court Portway Preston PR2 2YQ 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 Preston Private Nursing Home F57 F09 S6073 Preston Private V189509 090605 Stage 4.doc Version 1.40 Page 21 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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