Care Home: Park Hills Nursing Home

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What the care home does well Service users needs are assessed and regularly reviewed to ensure staff are aware of each individual`s current needs. There are effective ways of ensuring staff have up to date knowledge of each individual. People are treated with respect and their dignity is maintained. Service users have access to the full range of medical support available in the community, which helps to maintain their health and well being. Visitors are made to feel welcomed by the staff team and communication between relatives and the staff is good. The provision of food is good. Service users felt safe, in so far as they were protected from abuse or exploitation by the staff team at Park Hills. The service provides a pleasant, homely environment which is well maintained, clean and hygienic. Management overview of the care practice is undertaken rigorously. All service users and relatives who we spoke to during our visit, and comments received in the returned surveys were positive about their experience of the home. Comments included: "I am comfortable and looked after, cared for, excellently. They listen to me and fulfil my needs excellently."; " Park Hills is a very nice place to live"; "the home excels in the care of old people in residence both professionally and with understanding" . One visitor, when asked what the best thing about the home was replied " ... the care, and the dedication of the staff. I think it is a perfect home." Staff who we spoke to were also positive about the service they offered, the way they worked as a team and the support they received from senior staff. What has improved since the last inspection? The significant improvements identified at the previous key inspection had been maintained. All the requirements made at the last Key Inspection had been addressed. In particular this related to the way in which the home managed medication and the consistent implementation of audits (checks) to ensure that the care provided is maintained to a good standard and that this can be demonstrated. The recommendation regarding an aspect of good practice relating to medication, made at the previous random inspection, had also been addressed The management team had clearly put considerable energy and time into addressing the shortfalls identified at the previous two inspections. What the care home could do better: No requirements or recommendations about good practice were identified at this inspection. Key inspection report Care homes for older people Name: Address: Park Hills Nursing Home 199 Chamber Road Oldham Lancashire OL8 4DJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Steve Chick     Date: 1 5 0 6 2 0 1 0 This is a review of 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. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 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. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Park Hills Nursing Home 199 Chamber Road Oldham Lancashire OL8 4DJ 01616246671 F/P01616246671 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ms Barbara Rogers Name of registered manager (if applicable) Mrs Barbara Rogers Type of registration: Number of places registered: care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: 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 Physical disability - Code PD The maximum number of service users who can be accommodated is: 17 Date of last inspection Brief description of the care home Park Hills Nursing Home provides 24 hour nursing care and accommodation for up to 17 people over the age of 65 years. Mrs Barbara Rogers is the registered owner and manager of the home. 0 9 0 2 2 0 1 0 0 17 Over 65 17 0 Care Homes for Older People Page 4 of 27 Brief description of the care home The home is situated approximately one mile from Oldham town centre and is reasonably close to local amenities such as shops, pubs and local schools. Bus services are also available close by. The home is a Victorian property that has been extended at the rear. Entrance to the home is by a purpose built ramp at the side of the building. Well-maintained gardens are available outside the property. The home provides 17 single bedrooms, on both the ground and first floor and the majority of these are south facing. A passenger lift and other aids, such as hoists are available. There are three bathrooms. On the ground floor there is a choice of a large lounge/dining room or a smaller quiet lounge. A copy of the homes last inspection report was available from the main entrance area of the home. The weekly fees ranged from £338.70 to £535.81 dependent on the package of care required. Further details regarding fees and other information about the home are available from the manager. No additional charges are currently made. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. We (the Care Quality Commission) undertook a key inspection, which included an unannounced visit to the home. This meant that no one at Park Hills Nursing Home knew that the visit was going to take place. For the purpose of this inspection two service users were interviewed in private, as were three visitors to the home and three staff members. Additionally discussions took place with the Manager and administrator. We also looked at information we have about how the service has managed any complaints, what the service has told us about things that have happened in the service, these are called notifications and any relevant information from other Care Homes for Older People Page 6 of 27 organisations. Earlier in the year we had asked the management of the home to fill in a questionnaire, called an Annual Quality Assurance Assessment (AQAA). This is a legal requirement. The AQAA told us what they thought they did well, what they need to do better and what they have improved upon. For the previous key inspection surveys were sent to some service users and staff. Seven surveys were returned by service users and five by staff. Unfortunately they were not returned in time to be included in that report, but have been included in this report, where appropriate. We undertook a tour of the building and looked at a selection of service user records as well as other documentation, including staff rotas, and the complaints log. Since the previous key inspection we have undertaken one random inspection (unannounced visits which look at specific aspects of practice) done by a pharmacy inspector, to check how medicines were being handled. We have not received any complaints about the service since our last Key Inspection, nor have we been made aware of any safeguarding concerns. This key inspection was undertaken relatively soon after the previous one and information gathered on that occasion has also been used to inform our judgements. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: No requirements or recommendations about good practice were identified at this Care Homes for Older People Page 8 of 27 inspection. 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. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users needs are assessed before moving to the home to ensure that their needs can be appropriately met. Evidence: We were told by the manager that, other than in an emergency, service users have their needs assessed before a decision is made that Park Hills was an appropriate place for them to live. We saw examples of the homes assessment form which had been completed since the previous key inspection. These presented as identifying sufficient information to establish the primary needs of each person. Staff who we spoke to told us that they remained confident that service users needs were appropriately assessed and that they were competent to meet those needs. All the returned surveys from service users said that they received the care and Care Homes for Older People Page 11 of 27 Evidence: support they needed. Park Hills does not offer intermediate care. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users health, personal and social care needs are met by the consistent implementation of policies and procedures. Staff practices also serve to promote the dignity of service users. Evidence: We looked at a selection of service users files. All had a written care plan which had been regularly reviewed and when necessary, updated. There was a simple matrix on the office wall, showing when each care plan was due to be reviewed, which would minimise the risk of overlooking any review. The care plans presented as covering a comprehensive range of needs or potential needs. Generally the quality, and consequently the usefulness, of the information recorded was good. Each service user had a file in their room for staff to record that they had undertaken required tasks. These records were subject to frequent auditing (checking) by members of the management team which meant that they were up to date and accurate. Care Homes for Older People Page 13 of 27 Evidence: Staff who we asked, remained confident that their personal knowledge of service users combined with verbal handover at shift change and the written records gave them up to date information in connection with each service user. All service users who returned a survey to us said that they always received the care and support they needed and that staff listened and acted on what they said. All staff who returned a survey to us said that they always had up to date information about the service users and that the systems for passing information worked well either always (3) or usually (2). Service users who we asked, said that they believed they were treated with respect and had their privacy and dignity maintained. This view was also shared by the visitors who we talked to. Service users told us that even though they may be in their rooms (out of choice) for most of the day, staff are always passing and frequently check to make sure they are okay. Observation during our visit indicated that interactions between staff and service users were pleasant and relaxed. Visitors who we talked to were generally very positive about the care provided to the residents. One person told us that their relative was cared for beautifully and she is loved and I cant ask for anything else. Another relative observed that staff were good when helping service users to move and providing assistance with feeding. There was good documentary evidence that service users have access to the full range of medical services available in the community. All service users and visitors who we asked, expressed confidence that medical support, beyond that provided by the qualified nurses on duty, was obtained if necessary and in a timely manner. Shortly before this key inspection a random inspection (to check that medicines were being handled safely) was undertaken by a pharmacist Inspector. This was because previous visits had found serious shortfalls which may have had a negative impact on service users health and well-being. That random inspection found that all the requirements made at the previous visit had been satisfactorily addressed. It also found that medicine checks were regularly carried out which were efficient because they identified any mistakes and effective action was taken to help prevent them happening again. One recommendation was made by the pharmacist Inspector suggesting that medicines prescribed as when required should have more information about how they are to be used to help make sure they were administered correctly. At this key inspection there was good documentary evidence to confirm that Care Homes for Older People Page 14 of 27 Evidence: this recommendation had already been put into practice. Care Homes for Older People Page 15 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appropriate social contacts and activities are facilitated within the home which gives service users the opportunity for social fulfilment. The provision of food is good. Evidence: All service users who responded to our survey told us that activities were provided either always or (4) or usually (1). Many of the service users who live at Park Hills prefer to spend most of the time in their own rooms. Pleasant communal facilities are available but service users are not pressurised into using them. We were told by the manager that Age Concern Oldham were providing some support and training to staff to build on the existing practice of providing social activities on an individualised basis. Documentary evidence of this was seen. Each activity session is now recorded which provides good evidence of social activities provided on a one-to-one basis, in addition to the basic health and care needs for individuals being met. All visitors who we asked confirmed that they could visit at any reasonable time and Care Homes for Older People Page 16 of 27 Evidence: that they were welcomed by the staff team. one relative who has been visiting the home over several years described the staff as being like friends. Another visitor said they would not want their relative to go into an institutionalised care home. The management team have introduced a newsletter which, we were told, will be produced twice a year and aims to keep relatives and other interested parties up-todate with events at the home. During this unannounced visit to the home we sampled the lunch which was pleasantly presented and tasty. Service users who returned a survey to us all said that they liked the meals provided by the home either always (4) or usually (3). Service users who we asked said they liked the food. One person told us if you dont like anything you can tell them and they give you something in its place. Care Homes for Older People Page 17 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are protected from abuse or exploitation by the homes policies and practices and are confident that any complaints they may have would be dealt with appropriately. Evidence: Park Hills has a written complaints procedure which was found to be appropriate at the last key inspection. Since that inspection the threshold of when a complaint is recorded has been lowered by the management team. The complaints log was looked at and provided evidence that the staff continue to effectively address complaints and comments. All service users and visitors who we asked, expressed the view that they could complain and that any complaint would be dealt with. Similarly staff who we asked were confident that any complaints they passed on to senior staff would be followed up. All staff who returned a survey to us said they knew what to do if there were concerns about the home. All service users who returned a survey to us said that they knew who to speak to if they were not happy and all who answered the question (6) said they knew how to make a complaint. Staff who we spoke to understood the importance of remaining vigilant in connection Care Homes for Older People Page 18 of 27 Evidence: with the possibility of people living in the home being subject to abuse or exploitation. Staff told us that they believed the service users were safe and that the management team would take any necessary action to protect their interests. Staff also understood that there was an expectation that they would whistle blow if necessary. All service users and visitors who we asked expressed the view that people living at Park Hills were safe. One visitor described their relative as being as safe as houses. Care Homes for Older People Page 19 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this 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 is appropriately maintained, decorated and cleaned to enable service users to live in a pleasant, safe and hygienic environment. Evidence: During this unannounced at key inspection visit we undertook a tour of the building. This included communal areas and some service users bedrooms. Service users rooms provided evidence of a good range of personalisation and service users who we asked said that they liked their rooms. The home presented as well maintained, and no remedial issues were identified in connection with the fabric or fittings of the building. The building presented as clean and tidy with no unpleasant smells. Service users, visitors and staff who we asked, said that this was the normal state of the building. One service user said the building was very clean with staff hoovering every day. One visitor said that they spare nothing on keeping the place clean. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this 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 numbers and skills mix of staff on duty promotes the independence and wellbeing of service users. Evidence: We were told by the manager that staffing levels were usually provided on the basis of: -- 1 nurse and three carers between 08:00 -- 14:00; one nurse and two carers between 14:00 -- 22:00 and one nurse and one carer at between 22:00 -- 08:00. We were given a copy of the staff rota for the week beginning 7th June 2010 as evidence of this. Service users who we spoke to said that staff were available and responded promptly to the call buttons in their rooms. All service users who returned a survey to us said that staff were available when they needed them. Staff who we spoke to felt they were sufficient staffing levels and staff who returned a survey to us all said that there were enough staff on duty either always (4) or usually (1). We were told by the manager that training opportunities continued to be provided for staff. This was confirmed by staff who we asked. We were told that no new members of the care staff had been recruited since the last key inspection. We did not look at the staff files at this visit as they had been found, Care Homes for Older People Page 21 of 27 Evidence: at the last inspection, to demonstrated that appropriate checks, to protect the interests of service users, had been undertaken. All service users and visitors who we spoke to were positive about the care provided by the staff team at Park Hills. Comments made on service user surveys included staff always find time for a chat, and a laugh ... Park Hills is a very nice place to live. Everyone is always cheerful; nice friendly place and staff are all welcoming and they do their job to every need and are very nice and friendly. I couldnt ask for better excellent staff and care. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this 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 manager is competent to run the home, use the quality audit systems and implement the health and safety procedures for the benefit of service users and staff. Evidence: The proprietor, who is also the registered manager, has had many years experience of managing a care home. Since the last inspection the relatively new management team have consolidated their position. The support they provided to the manager appeared to have had a significant and positive impact on the running of the home. Several of the requirements from the previous key inspection related to the need to strengthen management checks on the care being provided. At this visit there was very good evidence that the importance of this aspect of running the home was well understood and was being rigorously implemented. Several service users and visitors who we spoke to during this visit, commented on the managers caring attitude and the positive impact this had on the care provided. Staff who we spoke to described their colleagues and managers as supportive, Care Homes for Older People Page 23 of 27 Evidence: approachable and helpful. We asked some staff what they believed to be the best thing about the care home and replies included: the staff group are very close and you get a good response from carers if you ask them; Barbara is a fantastic boss. We all work as a team. and the help you get if you need anything and Barbara as a boss. Quality assurance audits were undertaken routinely now. Relatives and residents had been asked to complete questionnaires which were being fed into the overall quality audit and planning for the home. We were told that no money was held on behalf of service users. If personal items not covered by the fees, were purchased for any service user, they were then invoiced for that amount. Staff who we asked told us they were clear about the expectation that they should report any health and safety concerns to management. Staff also told us that there was always a supply of personal protective equipment, such as disposable gloves and aprons, to minimise the risk of cross infection. We were told that all necessary routine maintenance and safety checks of equipment in use were undertaken. We looked at a small sample of maintenance and contract records to verify this. They presented as being satisfactory. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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