Care Home: Park Avenue Care Centre

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What the care home does well Staff carried out an assessment to see what help people would require if they decided to live in the home. Written information about the home was displayed in the reception area and people could visit the home to look at the facilities and ask questions. Residents received a contract. The contract explained what services were included in the fees.Park Avenue Care CentreDS0000058005.V376506.R01.S.docVersion 5.2Staff monitored residents health needs and sought advice from other health or social care professionals, if necessary. Relatives were happy with the care their family member received and said staff informed them about important issues. Staff followed good practice guidelines and kept excellent records about medicines. There was a clear audit trail to show how medicines were used in the home. The range and choice of activities provided in the home was good. Family and friends could visit at any time. Feedback about the home was positive and two residents said it was a pretty "decent" place to live. Food looked appetising and most people said they enjoyed their meals. The building was clean, fresh and well maintained. Residents could arrange their rooms to suit their needs. The home has a stable staff team. Residents said staff were kind and caring. There was a varied and relevant programme of training for staff. Thorough checks were carried out before new staff were permitted to work in the home. Regular checks were carried out to monitor the homes performance and to identify areas for improvement. Health and safety issues were well managed. Staff told us that management and senior staff were supportive and helpful. What has improved since the last inspection? What the care home could do better: Risks were identified but information was not always provided about the action staff should take to protect people. Staff did not always take account of recent changes when they reviewed risk assessments. Most of the staff supported residents to move in a safe and professional manner but we did observe some poor handling practice on one of the units. This could compromise resident and staff safety. Key inspection report CARE HOMES FOR OLDER PEOPLE Park Avenue Care Centre Park Avenue Care Centre 69 Park Avenue Bromley Kent BR1 4EW Lead Inspector Maria Kinson Key Unannounced Inspection 12:15 23rd and 29th April 2009 DS0000058005.V376506.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park Avenue Care Centre Address Park Avenue Care Centre 69 Park Avenue Bromley Kent BR1 4EW 020 8466 5267 020 8466 5367 laura.smith@excelcareholdings.com 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) Park Avenue Healthcare Ltd Arlette Beebeejaun Care Home 51 Category(ies) of Dementia - over 65 years of age (33), Old age, registration, with number not falling within any other category (18) of places Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP (maximum number of places: 18) Dementia - over 65 years of age - Code DE(E) (maximum number of places: 33) The maximum number of service users who can be accommodated is: 51 15th May 2008 2. Date of last inspection Brief Description of the Service: Park Avenue Care Centre opened in April 2004 and is located in a residential area of Bromley. Accommodation and facilities are provided over four floors, with access by passenger lift. The basement houses various services, such as a training room, hairdressing salon, kitchen and laundry. The remaining three floors accommodate residents, all in single bedrooms with en-suite facilities. The ground floor has 15 beds and the first floor 18 beds; both of these units are for older people with dementia that require nursing care. The second floor has 18 beds for older people that require nursing care. There is a garden to the rear and off-street parking to the front and side of the property. The fees for people that fund their own care range from £700.00 to £765.00 per week (this information was supplied to the commission on 01/05/09). The fees do not include personal items such as hairdressing, newspapers and private chiropody treatment. Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 5 Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was unannounced and was carried out over two days in April 2009. The inspector spent fourteen hours in the home. Before we visited the home we examined all of the information that we had received about the service such as concerns, notifications and the Annual Quality Assurance Assessment (AQAA) form. This helped us to decide which standards we should assess during the inspection and if we should look at any issues in more detail. We sent surveys to some of the people that work, live and visit the service, to obtain their views about the home. We received eight responses, five from relatives, one from a resident, one from a member of staff and one from a health care professional. During the inspection we spoke to six residents, six visitors and three members of staff. The feedback that we received helped us to form a judgement about the service. Some of the comments that people made about the home are included in this report. During the visit we examined some of the records that were kept in the home, observed staff supporting residents to eat and drink, move around the home and take their medicines. We visited all of the communal areas and viewed a selection of bedrooms on each floor. We carried out a random inspection in September 2008. A copy of the report relating to this visit can be obtained on request. What the service does well: Staff carried out an assessment to see what help people would require if they decided to live in the home. Written information about the home was displayed in the reception area and people could visit the home to look at the facilities and ask questions. Residents received a contract. The contract explained what services were included in the fees. Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 7 Staff monitored residents health needs and sought advice from other health or social care professionals, if necessary. Relatives were happy with the care their family member received and said staff informed them about important issues. Staff followed good practice guidelines and kept excellent records about medicines. There was a clear audit trail to show how medicines were used in the home. The range and choice of activities provided in the home was good. Family and friends could visit at any time. Feedback about the home was positive and two residents said it was a pretty “decent” place to live. Food looked appetising and most people said they enjoyed their meals. The building was clean, fresh and well maintained. Residents could arrange their rooms to suit their needs. The home has a stable staff team. Residents said staff were kind and caring. There was a varied and relevant programme of training for staff. Thorough checks were carried out before new staff were permitted to work in the home. Regular checks were carried out to monitor the homes performance and to identify areas for improvement. Health and safety issues were well managed. Staff told us that management and senior staff were supportive and helpful. What has improved since the last inspection? The Statement of Purpose was amended to include some additional information about the service. Extra dementia training was arranged. Most of the staff had now attended a dementia training session. There was more emphasis in the care plans about how the resident wanted staff to support them and how they wanted their care to be organised. Some residents attended a local church service and had visited a local park and café. Complaints records were filed in an orderly manner making it easier to locate information and see what action was taken to investigate and address concerns. Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 8 Senior staff spent time talking to staff about safeguarding procedures and training was provided about the homes whistle blowing procedure. Staff had a much better understanding of the action they could take to protect residents. Wheelchairs were moved from the top of the staircase to resident’s rooms. This ensures a clear passage for residents and staff. Most of the staff had attended bed rail training and regular checks were carried out to ensure that bed rails were fitted and working properly. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 9 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 Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 5. Standard 6 does not apply to this home. 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. People were advised to visit the home to view the facilities and talk to staff before they made a decision to move in. Staff carried out a care needs assessment to see what support the person would require and if the home could meet their needs. EVIDENCE: The registration certificate was displayed in the reception area. Staff had developed an information booklet called the ‘Statement of Purpose’ about the service. The Statement of Purpose was displayed in the home and was made available to visitors on request. The Statement of Purpose provides information for residents and their representatives about the facilities and Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 11 support that the home can provide. The booklet was reviewed and updated regularly. The arrangements for admitting new people into the home were satisfactory. Staff carried out a care needs assessment before people moved into the home. The assessment form prompts staff to consider specific areas of need and there was space for additional information or comments, if necessary. The assessments that we saw in residents files included information that staff had obtained from other professionals and the residents relatives. The form stated what support the person would require with activities such as moving, washing and dressing and communicating. After the assessment staff wrote to the person to confirm if the home would be able to meet their needs. A copy of the letter was seen on resident’s files. Some of the relatives that we spoke with said they visited Park Avenue Care Centre and several other local homes before they made their final decision. One relative said they knew as soon as they saw the home that their relative would like it. They added that if they had to make a decision again they would choose the same home. Relatives said they received two copies of the contract one of which they were asked to sign and return to the home. Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 12 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. 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. Residents were supported to manage health issues and access community health services but information about how potential risks should be managed was not always clear. Residents were protected by the records that the home kept and the procedures that staff followed when they handled medicines. People said staff treated them with respect and listened to their views. EVIDENCE: We examined five sets of care records for people that had recently moved into the home. All of the files included information about the persons care needs, risk assessments, a care plan and records about the support that people received in the home. Care plans provided clear information for staff about the support that people required and some plans included guidance about how Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 13 individual residents wanted staff to support them or the routines that they wanted staff to follow. This helps staff to provide individualised care. Care plans were well laid out and were reviewed regularly. Some of the plans were agreed and signed by residents or relatives. Staff completed a risk assessment when they identified potential risks. Some risks were identified by staff during the assessment process or were noted when the residents health declined. Two of the risk assessments that we saw did not provide adequate information for staff. In particular it was not always clear what action staff should take to protect residents. For example one resident wanted more ventilation in their room. A decision was made to remove the window restrictor. Although the assessment outlined the potential risks it did not state what staff should do to protect the resident. A bed rail assessment indicated that a resident was not at risk of climbing over the rails. Although the assessment was reviewed regularly, staff did not consider the recent entries in the daily care records which showed the resident had made several attempts to climb over the rails. See requirement 1. We received written feedback about the home from one healthcare professional that was in regular contact with the home. The person told us that staff seek and follow their advice. Clear and up to date notes were kept about the treatment that was offered to one resident with a wound. Staff advised people that were involved in the residents care that the resident had declined treatment. The GP visited the home regularly and people were referred to other health care professionals if specialist advice was required. We looked at the supply of medicines and medication charts for four residents. Staff kept good records about the amount and type of medicines that were received in the home. There were no gaps on the medication charts and the balance of all medicines was correct. This showed that people received their medicines regularly and on time. Information that was written on medication charts by staff was checked and countersigned by a second member of staff. All medicines were in stock. The medication storage area was clean, tidy and well organised. The room temperature was monitored to ensure that medicines were stored at a suitable temperature. Staff carried out regular audits to identify and address concerns. The findings from recent audits confirmed that medicines were well managed. Some medicines required special storage and record keeping arrangements. The register that was kept about the receipt, use and disposal of these medicines was up to date and storage facilities were secure. All entries in the register were checked and signed by two members of staff. Residents and relatives said staff were helpful and attentive. One relative remarked that “the care and understanding that staff have for residents is Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 14 remarkable” and added that this applies to all staff “from the matron to the cleaners”. One resident said staff always listened to their views and acted on what they said. We observed staff communicating and reassuring residents on all the units. There was some variation on the middle floor, but most of the staff that we observed engaged residents in conversation and told people what was happening. Laundry staff knocked on resident’s doors before entering the room to deliver fresh clothing. Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. 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. The home arranged a varied and interesting programme of activities and entertainment for residents. Relatives said they were able to visit at anytime and could spend as long as they liked with their family member. The food that was served in the home was varied and looked appetising. EVIDENCE: The home employs three part-time activity staff. There is usually at least one activity co-ordinator on each week-day and some days during the weekend. The weekly activity programme provides information for residents and relatives about planned activities and events. The programme was displayed on all of the units and in the lift. Activity staff spent time undertaking activities with residents on all of the units when they were on duty and sometimes took a group of residents to the activity room. Some of the resident’s artwork was displayed in the activity room and there were lots of reminiscence items to promote discussion between residents. Records were kept about group and ‘one to one’ activities that residents undertook and also stated if people did not Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 16 want to take part. The records showed that people were encouraged to take part in a wide range of stimulating activities in the home. In the period since the last inspection some of the residents attended a service at a local church or visited a local café and park. Staff should continue to explore opportunities for residents outside the home. Residents said they enjoyed the outside entertainers that visit the home and one resident told us that they particularly liked the choir. The home is hoping to introduce a new communication tool called ‘Talking Mats’. The tool will help people who suffer from communication difficulties to express their needs. Arrangements were being made to train staff before the tool is introduced. Relatives said they were able to visit the home at any time and could spend as long as they wanted in the home. Some people mentioned how the receptionist always made them feel welcome and that care staff offered them refreshments and showed an interest in their welfare. Visitors said there was always a senior member of staff available for them to talk to and one relative said “communication on all levels is excellent”. Relatives meetings were held in the home and family members that could not attend the meetings were offered a There were regular meetings for Staff said they encouraged residents to choose what they ate, where they sat and what they wore but told us that some residents found it difficult to make these choices. One resident told us that they could decide where and how they spent their time and said they could go to bed and get up when they wanted to. Relatives said staff talked to them about their family member’s care needs and always informed them about significant events such as accidents and health issues. We observed staff serving lunch on two of the units and supper on the ground floor. The dining rooms were nicely laid out and welcoming. Menus were displayed on the tables and residents were offered a choice of juice. Food was well presented and looked appetising. We received mixed feedback from residents and visitors about the food provided in the home but most of the comments that we received were positive. One person described the food as “institutional”, another person said the meat “literally falls away from the bone” and one relative said the food was always good. The chef had recently revised the suppertime menu to provide more choice and a new summer menu will provide an extra course at lunchtime. Staff provided support to eat where necessary. Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. 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. People knew who to speak to if they wanted to make a complaint. Concerns were dealt with quickly and effectively. Staff understanding of abuse had improved understood how to protect people from abuse and how they could report concerns. EVIDENCE: The home had received a number of cards, letters and emails complimenting and thanking staff for supporting residents. The complaints procedure was displayed in the reception area and information about the procedure was also included in the service user guide. There was a suggestion box in the reception area and the company had recently introduced a free phone number that people could use to report concerns. Relatives knew how to make a complaint and people that had raised concerns in the past were happy with the way their concerns were managed. The home had received five complaints in the past year. Most of the complaints were about non care issues such as lost laundry and were investigated and resolved quickly. Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 18 The complaints file had been re-organised, making it much easier to locate and track information. We looked at five complaints, all of which were received in 2009. There were clear records about the complaint, the investigation and the action that was taken to address concerns. All of the complaints that we looked at were dealt with promptly and effectively. In the period since the last inspection we received two complaints about the service. We carried out a random inspection in September 2008 to assess one issue that was raised about the service. We did not identify any concerns during our visit. The second complaint was addressed by staff, before we contacted the home. We were concerned that the home was not taking adequate action to protect people from abuse at the last inspection and received further information in 2008 that reinforced this view. We sent the home a warning letter in December 2008 requesting an improvement plan. We assessed some aspects of the plan during this inspection. In the period since the last inspection senior staff had spent a considerable amount of time talking to staff during meetings and supervision about the homes safeguarding procedure. Most of the staff that we spoke to had attended a safeguarding training session or had discussed the issue during induction training. All of the staff that we spoke to knew that they must report allegations, unexplained injuries and concerns to senior staff or the manager. Staff were familiar with the whistle blowing procedure and knew they could use the procedure to let the company know about poor practice and health and safety concerns. The manager told us about significant events that occurred in the home such as unexplained injuries and accidents. In the period since the last inspection the local authority investigated one complaint under their safeguarding procedures. Some of the concerns that were raised by the complainant such as nail care, staffing levels, the supper menu and fluid intake were considered during this inspection. We did not identify any concerns about these issues. Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24 and 26. 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. All of the areas used by residents looked homely and welcoming and were clean, tidy and comfortable. EVIDENCE: A maintenance person visited the home regularly to undertake repairs and to carry out health and safety checks. The building was well maintained and all of the equipment that we saw was in working order. We viewed two bedrooms on each floor. Bedrooms were spacious and residents could arrange the furniture to suit their needs. Although the rooms were furnished some residents were using some of their own furniture and had Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 20 made the room their own by displaying some of their ornaments and photographs. All of the rooms had a private en suite toilet and shower and additional toilets were located near the lounge and dining areas. There was one assisted bathroom on each floor. The communal areas were pleasantly decorated and comfortable. There was a television and music centre in the communal rooms. There was a regular re-decoration programme and arrangements were being made to fit carpet in the lounges. The garden consists of a lawn area and patio. Although the area was well maintained it did lack interest and colour. As we left the home we saw a staff member planting bedding plants in the raised border and we were told that a water feature had been purchased for the garden. All areas were clean and fresh. There was hand washing facilities in all of the toilets and hand gel on all of the units. Clinical waste was stored in lidded bins. The local authority inspected the main kitchen in January 2009. The home was awarded four stars, which indicates food hygiene standards were very good. Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 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. The home has a stable team of staff. This provides good continuity of care for residents and support for relatives. Staff were trained and supported to deliver good quality care. Residents were protected by the homes recruitment procedures. EVIDENCE: Staff carried out their work in a calm manner and responded promptly to requests for assistance. There were adequate staff on all of the units to meet people’s needs. Residents and relatives told us that staff were “patient”, “understanding” and “caring”. The home had not used any temporary staff in recent weeks. This provides good continuity of care for residents. 71 of care staff had a National Vocational Qualification in Care (NVQ) or an equivalent qualification. This exceeds the standard set by the Department of Health. Some staff were working part time work whilst studying for a NVQ qualification in care at level four. The recruitment records for two most recently appointed members of staff were examined. The files were well organised and contained all of the Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 22 necessary documents. A visit by a Border and Immigration officer indicated staff recruitment records were “carefully filed”. The home ensured that adequate records were obtained before staff that did not have a criminal record bureau disclosure were allowed to work in the home. It would be good practice to record the name of the person that will supervise the staff member on the form. The home provides a varied range of relevant training sessions for staff, some were facilitated by senior staff and some were provided by external trainers. The home has a dedicated training room with a computer which can also for their personal studies or to complete distance learning training courses. Since the last inspection some of the staff had attended food hygiene, medication awareness, health and safety, moving and handling, safeguarding adults, whistle blowing, dementia, wound care, challenging behaviour, infection control, communication, first aid, fire warden, customer care, nutritional assessment, end of life and bedrail training sessions. We received one comment card from a person that worked in the home and spoke to three members of staff during the inspection. Staff were satisfied with the training and support that they received in the home. Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 23 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. 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. The home was well organised and managed. There were good systems in place to monitor and improve the quality of care provided in the home and to identify and address health and safety issues. EVIDENCE: The manager was assessed by the commission to have suitable skills and experience to manage a care home for older people. The manager is a registered nurse and has a management qualification. Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 24 Staff said the manager and deputy manager visit the units regularly to talk to residents and to discuss resident care issues. Records were kept about staff meetings. The minutes from a recent meeting showed that staff were informed about a new training session and were told about the outcome of inspections and audits. We received positive feedback about the home from residents and relatives. A number of people described the home or the care that their family member received in the home as “excellent”. One person said “I can’t fault this place”. The home has a comprehensive quality assurance system. A senior member of staff from the company visits the home at least once a month to assess the conduct of the service and to speak with residents and staff. A report was sent to the manager about their findings and included an action plan if concerns were identified. The regional manager had recently completed a night audit to check that residents were receiving appropriate care. The deputy manager completed regular audits to check staff were following medication, record keeping and health and safety procedures. Areas for improvement were identified and addressed with staff. The company sent surveys to residents, relatives and health and social care professionals twice a year to obtain feedback about the service. The results from surveys were collated and an action plan was developed to address concerns. Responses from a recent survey were positive but some relatives were not aware that their family member had a key worker. We were told that the home does not hold any personal money or valuable items for residents. Relatives were invoiced directly for services such as hairdressing or newspapers, and some residents were able to look after their own money. Maintenance staff carried out a programme of health and safety checks at regular intervals and completed routine repairs within the home and grounds. There were regular fire alarm tests and drills and fire safety equipment was inspected by a specialist company. Equipment such as hoists, passenger lifts and weighing scales were serviced regularly. Gas and electrical appliances were inspected to ensure they met safety standards. Staff checked bedrails were fitted and working properly. We observed staff supporting residents to move around the home and helping people to transfer from chairs to wheelchairs. Most of the transfers that we saw were carried out safely but we did observe some poor practice on the middle floor. The manager arranged urgent moving and handling training for the staff on this unit as soon as she became aware of the issue. See recommendation 1. Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 25 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 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 4 10 3 11 X 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 3 3 3 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 4 X N/A X X 3 Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 26 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. 1. Standard OP7 Regulation 13 Requirement Risk assessments must include guidance for staff about the action they should take to protect residents. Staff must consider recent events, when reviewing risk assessments. Timescale for action 04/09/09 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 OP38 Good Practice Recommendations Staff should follow safe moving and handling guidelines. Management should monitor staff practice. Park Avenue Care Centre DS0000058005.V376506.R01.S.doc Version 5.2 Page 27 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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