Care Home: Alt Park

What the care home does well The home provides a high level of care within a bright and pleasant environment. Records provide detailed information regarding the care required by service users and evidence of the actual care given. Staff are well trained and the turnover of staff is low resulting in a consistent level of care given at all times. What has improved since the last inspection? The programme of redecoration and refurbishment has continued to improve the standard of the environment. All areas are bright and clean and provide service users with a pleasant place in which to live. The number and quality of activities is now high with all service users being offered a choice of activities to suit their individual preferences. CARE HOMES FOR OLDER PEOPLE Alt Park Alt Park Parkstile Lane Gillmoss Liverpool Merseyside L11 0BG Lead Inspector Jeanette Fielding Key Unannounced Inspection 2nd July 2008 10:00 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 Alt Park DS0000063172.V367664.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. Alt Park DS0000063172.V367664.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alt Park Address Alt Park Parkstile Lane Gillmoss Liverpool Merseyside L11 0BG 0151 546 5244 0151 5486580 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) Tudor Bank Ltd Miss Lorraine Jones Care Home 35 Category(ies) of Dementia - over 65 years of age (35) registration, with number of places Alt Park DS0000063172.V367664.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Up to 35 elderly persons who have dementia requiring nursing care Up to 10 elderly persons who have dementia requiring personal care A maximum of 35 persons to be accommodated at the home Date of last inspection 10th July 2006 Brief Description of the Service: Alt Park is registered under the ownership of Tudor Bank Ltd, a company that has extensive experience of the care home business. The registered manager of the home is Lorraine Jones who is a qualified nurse and an experienced manager. Alt park is registered to provide personal care and nursing care for elderly people who have dementia. It is registered for thirty-five service users, ten of whom may be accommodated for personal care. It is situated in the Gillmoss area of Liverpool. Accommodation is located on two floors with access to all areas of the home by a passenger lift. All bedrooms are for single occupancy, five of which have en-suite facilities. There are two lounges, a dining room and a conservatory. The home is surrounded by attractive and well kept gardens. Local shops and amenities can be found a short distance from the home. The fees charged by the home are £395 to £476 plus the assessed nursing element of care needs, dependent on the level of care required. Alt Park DS0000063172.V367664.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use the service experience good quality outcomes. This inspection took place over a period of five and a half hours. This was the key unannounced inspection and was carried out as part of the regulatory process. As part of the inspection process, all areas of the home were viewed including many of the service users bedrooms. Assessments and care plans for five service user were inspected together with staff records and certification to ensure that health and safety legislation was complied with. Discussion took place with the manager, nurses, care staff, service users and visitors to the home to obtain their views and opinions of the service. If this was not possible due to communication difficulties, then through observing people using the service. The manager had completed an Annual Quality Assurance Assessment which gave further insight into the home. What the service does well: What has improved since the last inspection? What they could do better: The home should continue to develop to maintain the high level of care and facilities for the service users. Alt Park DS0000063172.V367664.R01.S.doc Version 5.2 Page 6 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. Alt Park DS0000063172.V367664.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 Alt Park DS0000063172.V367664.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 good. This judgement has been made using available evidence including a visit to this service. Prospective service users and their families are provided with full information regarding the home and the services offered to enable them to make an informed decision regarding their care provider. EVIDENCE: The home has produced a detailed Service User Guide to inform all current and prospective service users with information regarding the facilities and services offered by the home. This has recently been reviewed and updated. A copy of this is placed in each bedroom and is also displayed in the foyer of the home. Copies are also issued to all prospective service users and their families. Additional copies are available from the manager on request. Alt Park DS0000063172.V367664.R01.S.doc Version 5.2 Page 9 Pre-admission assessments are undertaken on all prospective service users to ensure that their individual care needs are identified All prospective service users are assessed with regard to their care needs prior to admission. These assessments are undertaken by the manager or one of the senior nurses. The care files of service users recently admitted to the home were inspected and were found to contain detailed information regarding their health, care and social needs. Information is gathered from the service user, their family and any other healthcare professional involved in their care. Sufficient information is gathered to enable the initial plan of care to be prepared and to identify any specialist equipment necessary for the home to meet the individual needs of the service users. The home does not offer intermediate care. Alt Park DS0000063172.V367664.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are detailed and provide staff with full information to enable them to give the appropriate level of care to each individual service user so as to meet their needs. EVIDENCE: Individual care plans are produced for each service user. The care plans are reviewed on a regular basis and are rewritten whenever the service users’ needs change to ensure that the staff have full information regarding the care to be given. All health, social and emotional care needs are identified and the plans are discussed with the service users’ relatives as the service users do not have the capacity to agree with them. The relatives are requested to sign the plans to indicate their agreement with them. The manager regularly audits the care plans to ensure that they are updated and maintained accurately. A Alt Park DS0000063172.V367664.R01.S.doc Version 5.2 Page 11 random selection of files were inspected and all were found to contain information to ensure that the service users needs can be met. The daily records, and the care files, provide evidence of visits to and by other health care professionals and give details of the information and advice offered by these professionals. The daily records also provide evidence of the actual care given and of how the service users have spent their day. Detailed information is recorded regarding the individual service users’ activities of daily living and this provides sufficient information for agency or bank staff to enable them to provide the appropriate level of care in the event that the manager or regular staff not being available. Service users are offered choices with regard to their personal care and are encouraged to maintain their independence as much as possible. The home has a comprehensive medications policy and inspection of the medications showed that the procedure is followed accurately. All medication records were found to be well maintained and up to date. The medications room and trolley were clean and organised. Appropriate arrangements are in place for the disposal of unwanted medications. Regular audits are undertaken on medications by the manager to ensure that accuracy is maintained. None of the service users were able to express their views of the home due to their cognitive impairment and there were no relatives visiting the home at the time of the site visit. Service users and staff were observed during the visit and it was evident that service users were comfortable with the staff. Staff spoke to them in a dignified manner and showed affection. Service users smiled at the staff when they were spoken to and gave the view that they were happy. Staff were observed to treat service users with respect and spoke in a quiet and calming manner and accompanied them along corridors whenever necessary. Many of the service users are fully mobile and it was evident that they were free to use the communal areas, their own bedroom or the garden as they wished. The door to the garden was left open for them to give full access and to avoid restrictions on movement. Alt Park DS0000063172.V367664.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are stimulated and entertained through a high number of social activities within the home. EVIDENCE: A personal social profile has been prepared for each service user to identify the social activities they enjoyed prior to living at the home. This has been prepared with relatives and has proved to be beneficial when planning the activities programme. The home employs an activities co-ordinator who has planned a programme of activities for the service users. Both group and individual activities are provided and the care staff are involved in these. On the day of the site visit, a group of service users were making cakes. Other activities include quoits, music, singing, board games and nail care. Classical music is enjoyed by service users and a small group were observed to be humming along to the music. Entertainers visit the home to provide additional enjoyment. Visits to local events are arranged. Members of the clergy visit the home on a regular Alt Park DS0000063172.V367664.R01.S.doc Version 5.2 Page 13 basis and provide services for those who wish to participate. Service users right to follow their religious beliefs are acknowledged and encouraged. The home does not have any religious persuasion. Many of the service users enjoy spending time in the garden and have been involved in filling pots and hanging baskets. New garden furniture has been provided and includes sturdy tables and chairs. The garden is pleasant and secure and access to this area is always available during the day. Meals are serviced in the dining room, the lounge or in the service users own bedroom as they wish. Dining tables are attractively laid and the dining room is bright and pleasant. A new cook has been employed and menus have been reviewed. A choice of meals is always available and information regarding service users food likes and dislikes is held. The meals served on the day of the site visit looked and smelled appetising. Drinks and snacks are offered between meals and are available on request at all times of day and night. Alt Park DS0000063172.V367664.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All staff have been given training on the Protection of Vulnerable Adults and have a good knowledge and understanding of Adult Protection issues which protects service users from abuse. EVIDENCE: The home has a robust complaints procedure which is detailed in the Statement of Purpose and Service User Guide and is also displayed in the foyer of the home. The Service User Guide is in each bedroom and so this information is available for relatives and visitors to have full information. No complaints have been received by the home, or by CSCI, since the last inspection. All staff have been given training on the Protection of Vulnerable Adults and discussion with them confirmed that they are aware of the action to be taken in the event of abuse being suspected. The home also has a whistle blowing policy and all staff have been given information on how to report events to the manager in confidence. Alt Park DS0000063172.V367664.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a bright, clean and homely environment for service users to give them a safe and comfortable place in which to live. EVIDENCE: All areas of the home are decorated and furnished to a good standard. The lounge and dining room are bright and welcoming. New armchairs and dining room furniture have been provided since the last inspection. New carpets and flooring has been provided in the communal areas. Seating areas are provided in the lounge, dining room, conservatory and entrance area to offer service users with a choice of where they spend their day. Alt Park DS0000063172.V367664.R01.S.doc Version 5.2 Page 16 Two purpose built shower rooms have now been installed to provide additional facilities for service users. These have proved very popular with the service users who can be safely bathed by the staff with very little effort. Orientation is provided for service users. Toilet doors are painted a different colour to the remainder of the home for ease of identification. The manager explained that work is underway to provide easier identification of bedroom doors for service users by the use of personalised pictures or photographs. Staff and relatives have been involved in personalising service users bedrooms to provide a warm and homely environment. Small items of furniture, pictures, photographs and items of memorabilia enhance the environment for the service users. Security locks are fitted to external doors and to the passenger lift to provide greater protection for the service users. These locks are connected to the fire alarm system and will unlock automatically in the event of the fire alarm sounding. The home is maintained to a high standard, with health and safety issues being addressed as soon as they are identified. The gardens are well maintained and a secure area, with seating, is accessible for service users at all times during the day. All areas of the home were observed to be clean, tidy and organised and there were no unpleasant odours. Alt Park DS0000063172.V367664.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff training continues to develop knowledge and understanding and ensure that service users needs are met effectively. EVIDENCE: The home employs qualified nurses and care assistants to provide care to the service users. The home also employs catering, laundry, housekeeping and maintenance staff to ensure the smooth running of the service. The home has produced a robust recruitment procedure and inspection of staff recently appointed to the home provided evidence that the procedure is followed. All prospective staff are required to complete an application form prior to attending for interview. A record of the interview outcomes is held on the files. Two references are taken and checks are made on the Criminal Records Bureau and Protection of Vulnerable Adults registers to ensure that service users are protected. Alt Park DS0000063172.V367664.R01.S.doc Version 5.2 Page 18 All new staff are required to complete an induction training programme. A work book is used to provide evidence of the training. Competencies are assessed by the manager and are recorded in the work book. Staff training continues to be given and 50 of the care staff hold NVQ qualifications. The housekeepers have also achieved NVQ qualifications. Six of the care staff are undertaking distance learning training on dementia awareness and four staff are being given training on health and safety. Training is also give by other healthcare professionals and arrangements are in place for a dentist to give training to the staff. All staff have been given training on the Protection of Vulnerable Adults and this training is also given during the induction programme. The catering staff hold relevant qualifications and full information is available to housekeeping and laundry staff on COSHH. All staff are given regular supervision and annual appraisals are held. Records of supervision and appraisals are held on the staff files together with supervision contracts. Alt Park DS0000063172.V367664.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a robust and effective management structure in place to ensure the protection of all staff and service users. EVIDENCE: The registered manager is a qualified nurse who has achieved NVQ in management at level 4. She is skilled and experienced in the care and management of homes for elderly people who have dementia. Alt Park DS0000063172.V367664.R01.S.doc Version 5.2 Page 20 Regular staff meetings are held and provide a forum for open discussion and for the dissemination of information. Minutes are taken of these meetings and are available for inspection. Health and safety are given a high priority with in the home and all issues are addressed as soon as they are identified to ensure the protection of staff, service users and visitors to the home. Regular tests are made on the fire detection equipment and detailed records are held. Fire drills are held on a regular basis to ensure that the staff are fully aware of the action to be taken. Checks are made on all equipment within the home and certificates of safety are held. All were found to be in place and up to date. Questionnaires have been sent to relatives to gather their views on the home. The manager speaks with service users and relatives on a daily basis. The Regional Manager visits the home on a weekly basis to support the manager, and the Responsible Individual visits on a regular basis to speak with the manager, staff, service users and relatives, and to tour the premises. A report is produced on a monthly basis, as required, and was available for inspection. Alt Park DS0000063172.V367664.R01.S.doc Version 5.2 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 X 3 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 3 X 3 X X 3 Alt Park DS0000063172.V367664.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Alt Park DS0000063172.V367664.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries.northwest@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 Alt Park DS0000063172.V367664.R01.S.doc Version 5.2 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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