Inspection on 05/11/07 for Queen Elizabeth Park

This inspection was carried out on 5th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Queen Elizabeth Park 27/06/06

Queen Elizabeth Park 13/12/05

Queen Elizabeth Park 23/11/04

Queen Elizabeth Park 24/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Queen Elizabeth Park 1-72 Hallowes Close Guildford Surrey GU2 9LL Lead Inspector Tina Thomas Unannounced Inspection 11.00 5 November 2007 th 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 Queen Elizabeth Park DS0000054733.V353336.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. Queen Elizabeth Park DS0000054733.V353336.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Queen Elizabeth Park Address 1-72 Hallowes Close Guildford Surrey GU2 9LL 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) 01483 531133 katarina.parr@carebase.org.uk CareBase (Guildford) Ltd Katarina Parr Care Home 77 Category(ies) of Dementia (26), Old age, not falling within any registration, with number other category (51) of places Queen Elizabeth Park DS0000054733.V353336.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th June 2006 Brief Description of the Service: Queen Elizabeth Park is a new, purpose built care home registered to provide care for up to 77 older people, including the care of 26 Service Users with dementia, 26 with nursing needs and 25 requiring residential type care. The home is divided into three units and the accommodation is set out on three floors. All rooms are single occupancy with en-suite facilities. The current range of fees charged is £650 to £900 per week. The home is situated in a residential area of Guildford. There is a garden to the rear and the side of the property and there are adequate parking facilities within the grounds. Queen Elizabeth Park DS0000054733.V353336.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection process took place over a period of time, information was gathered, and it concluded with an unannounced site visit. This means that people at the home including the staff did not know the inspection was going to take place. The inspection looked at key standards. Judgements were made by taking into account evidence from a range of documentation including a tour of the home, views of people living at the home, staff surveys and discussion with the Manager. The Homes AQAA (annual quality assurance assessment) also produced evidence for this inspection. What the service does well: The manager undertakes an in depth pre-admission assessment to ensure that the home can meet the needs of prospective residents. The manager and staff produce, together with people living at the home or their supporters, care plans that clearly reflect the needs, wishes and expectations of people who choose to live at the home. People are treated as individuals. People are encouraged and enabled to remain as independent as possible. The manager and staff have fostered good relationships with other health care professionals who come to the home and are part of people’s multidisciplinary care. People are treated with dignity. The home is a clean, safe and cosmetically attractive environment. Family members, friends and supporters are made welcome at the home. Staff are well trained to understand the needs of the people living at the home. The home has robust quality assurance procedures. Reflective practice is used to ensure continuous improvement for the benefit of the people living at the home. The home is well managed. Queen Elizabeth Park DS0000054733.V353336.R01.S.doc Version 5.2 Page 6 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. Queen Elizabeth Park DS0000054733.V353336.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 Queen Elizabeth Park DS0000054733.V353336.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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People choosing to live in the home are given comprehensive information so that they can make an informed choice. Excellent pre-admission assessments ensure that peoples needs and wishes can be met in the home. They also ensure that peoples future care is personalised Standard 6 is not applicable at this home. EVIDENCE: People who choose to live at the home are given lots of information, some of which is pictorial, so that they can make a considered opinion regarding Queen Elizabeth Park DS0000054733.V353336.R01.S.doc Version 5.2 Page 9 whether they would enjoy day to day life at the Queen Elizabeth Park care home. The manager undertakes all pre-admission assessments. The pre admission assessment is in-depth and holistic. It takes into account not only peoples physical, psychological and social needs but their past lives, their expectation of care in a care home, their wishes regarding care and their hopes and their aspirations for the future. The documentation is of excellent quality. The home has a Gold Standards Framework Award. The Gold Standards Framework is an accredited award. It promotes excellence in end of life care for people. The pre admission assessment gathers information, which enables people’s future care to be personalised. Information from care managers and other health care professionals are considered at pre-admission assessment. Queen Elizabeth Park DS0000054733.V353336.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): 7,8,9,10,11 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People receive individual and personalised care in a dignified manner. This includes palliative and end of live care. Care is regularly reviewed and evaluated. People are enabled to live their lives and receive care in a manner they choose. EVIDENCE: The home uses a care plan tool, which is very comprehensive. It was created with the assistance of the Alzheimer’s society national institute of clinical excellence guidelines for caring with people with dementia, the national minimum standards and the national service framework for older people. Queen Elizabeth Park DS0000054733.V353336.R01.S.doc Version 5.2 Page 11 The home also has excellent care planning in regard to palliative care and care of the dying. They use the recognised Liverpool pathway and Gold Standards Award Framework. The Gold Standard Framework enables the home to manage people’s goals and expectations. People and their families have a large input into the care plans, which is clearly evidenced. Care is very personalised. Records of care are well documented, for example wound care, pain control, nutrition, and continence. There is evidence that care is carefully audited and evaluated to ensure that people receive the very best of care. The manager and staff have forged good relationships with other health care professionals and welcome input from local GP’s PCT lead nurses, psychiatry at Farnham Road and McMillan nursing among others. The home is well equipped to meet people’s needs and aid independence. Medication is managed over three floors with three treatment rooms and three medicine trolleys in place. The home has a policy in place for the administration of medication. The manager and staff audit the medication on a monthly basis. A pharmacist audits medications twice a year. The manager is a nurse prescriber although she does not currently prescribe this is a consideration for the future that could benefit people who live in the home. The home has access to palliative care medication stock. All staff administering medication have appropriate training. People at the home discussed how they were treated with dignity by the staff and how they had been enabled by the staff and facilities in the home. Some recognised that they were more able than prior to being in the home, due to the use of the appropriate facilities. All rooms are single en-suite. Personal care is delivered in bathrooms or peoples own bedrooms. Queen Elizabeth Park DS0000054733.V353336.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): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Peoples lifestyle expectations are met and their preferences catered for. Relationships with family, friends and supporters are facilitated. Meals are wholesome and nutritious. EVIDENCE: The pre- admission assessment discusses in depth with people their expectations, likes, dislikes, current activities and aspirations for the future. The manager could evidence and people discussed, how they were able to continue with social activities they had taken part in prior to living at the home. Some people continue to visit day centres. The home has a social secretary who plans a weekly activities programme on a weekly basis with the manager. The activities are many and varied and Queen Elizabeth Park DS0000054733.V353336.R01.S.doc Version 5.2 Page 13 regularly changed to meet the needs of different people and client groups. People’s activities are reviewed and discussed with them on a personal level once a month. People at the home have access to the internet and some speak to their families through skype. Some have their own internet accounts. People living at the home confirm that their family and friends are made welcome. They can see them in their own room or in any of the communal areas if they choose. The Gold Standard Framework Award facilitates close working with family, friends and supporters. A menu is drawn up weekly and given to residents. People are asked on a daily basis what they would like to choose. The menu is wholesome and nutritious. The home can cater for special diets. People’s relatives are welcome to stay for meals. It was observed that when people needed assistance it was undertaken in a dignified manner. People had equipment i.e. plate rims to enable to be independent with eating. Queen Elizabeth Park DS0000054733.V353336.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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to allow peoples concerns to be heard. People are protected from abuse by the homes policies and procedures. EVIDENCE: People at the home confirmed that they knew how to make complaints and felt confident to approach the manager if necessary. The home has a complaints policy and a copy is in the homes service users guide. A copy of which everyone gets prior to admission to the home. Advocacy is discussed with people at the pre-admission stage. The home provides each person with a list of available advocates should they wish to use and independent advocate. The manager has been proactive in reporting any potential safeguarding issues to the adult protection team. Safeguarding issues reported have not always directly involved the homes staff or practices, but have potentially affected residents. Queen Elizabeth Park DS0000054733.V353336.R01.S.doc Version 5.2 Page 15 The manager believes the home/staff has on occasions taken learning points from POVA issues. The manager has been resolute in her steer for professionalism around Safeguarding of Adults and has documented/evidenced this well in the homes Annual Quality Assurance Assessment (AQAA). This helps to keep people in the home safe. The manager and staff have undertaken non-violent crisis intervention training. This has resulted in an 80 decline in episodes of physical aggression from people living at the home. The manager has facilitated a ‘chill out’ area for staff so that they can have a break if necessary from the demands of caring for people with challenging behaviour. This addresses the well-being and safety of the people living in the home and the staff. Queen Elizabeth Park DS0000054733.V353336.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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is purpose built and its lay out is conducive to the service user groups it caters for. The home is clean, well maintained and cosmetically attractive throughout. EVIDENCE: Queen Elizabeth Park is a purpose built care home. The Provider has adapted some of the facilities in line with people’s preferences and changing needs, for example people in the home asked for the patio to be extended and one bathroom was changed to a shower room to meet peoples preferences. Queen Elizabeth Park DS0000054733.V353336.R01.S.doc Version 5.2 Page 17 Accommodation is arranged over three floors with ample communal facilities provided on each floor, which includes well furnished dining rooms and lounges. The accommodation is fit for purpose. Furnishings are cosmetically attractive. The home is spacious. This allows ease of use and storage of equipment such as hoists and wheelchairs. The small communal areas and spacious corridors lend themselves well to dementia care. All bedrooms are single with en-suite facilities. Individual accommodation is comfortably furnished and people can bring their own furniture and possessions into the home with them. One person was awaiting artwork recently bought from home to be mounted, once they had made a final decision of where they wanted it to be placed. They were also having a shelf put up in their room so they could display some of their possessions. The homes AQAA demonstrates incidents were people have decorated their own rooms to reflect their ethnic background. The home is clean and hygienic and has no foul odours. The laundry is located in the basement and is well equipped and staffed. Queen Elizabeth Park DS0000054733.V353336.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): 27,28,29,30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are well inducted and trained. Robust recruitment procedures help to keep people safe. EVIDENCE: The home has suitable numbers of staff to meet the needs of the current residents. People at the home said that they did not feel rushed by the staff. Nurses and care staff are well trained. They have a suitable induction in line with skills for care. Staff have undertaken training to meet the Gold Standard Framework Award. Some staff have undertaken dementia training with Sterling University. More than 50 of staff are trained to NVQ level 2. The chef is NVQ trained and the domestic staff are working towards NVQ 2 in housekeeping. All mandatory training is in place and regularly updated. Staff files showed that the homes recruitment procedures are adhered to. Volunteers are vetted in the same manner. Queen Elizabeth Park DS0000054733.V353336.R01.S.doc Version 5.2 Page 19 Queen Elizabeth Park DS0000054733.V353336.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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed. It is run in the best interest of the people that live there. EVIDENCE: The management structure within the home is excellent. The registered manager is a registered Part 1 nurse and also has a master’s degree in business management. She has 8 years mental health experience and has ongoing development in all these areas and of palliative care, the manager is supported by the new Business Manager and Chairman. The manager returned to the Commission an AQAA of excellent quality. This is a quality assurance tool which looks at what the home does well, what has Queen Elizabeth Park DS0000054733.V353336.R01.S.doc Version 5.2 Page 21 improved in the past year and what could be improved in the next year. The manager has adopted reflective practice in her management style. Surveys from staff evidenced that there was an ‘open culture’ in the home. The home has a business planning process in place, which facilitates the review of all systems. By monitoring, evaluating and appraising systems inclusively with staff and people living at the home the manager has been able to measure achievements to ensure development. Quality assurance tools include environmental audits, staff induction, training, and supervision, the Gold Standard Framework Award, Investors in people and City and Guilds registration. The manager and staff at Queen Elizabeth Park do not handle the money of people living there. The manager ensures that there are suitable health and safety risk assessments in place. Safe working practices are audited and actioned. Staff receive suitable training. There is a service contract for all fundamental systems. Queen Elizabeth Park DS0000054733.V353336.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 4 x x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 4 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 4 4 3 x x 4 x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 4 x 3 x x 3 Queen Elizabeth Park DS0000054733.V353336.R01.S.doc Version 5.2 Page 23 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. 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. Refer to Standard Good Practice Recommendations Queen Elizabeth Park DS0000054733.V353336.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 Queen Elizabeth Park DS0000054733.V353336.R01.S.doc Version 5.2 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!