Care Home: Park House

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What the care home does well Each person who comes to live at Park house is assessed so that they know their needs can be met. All the people who live at Park House have an individual care plan in place so that staff know what they need to do for each person. There is enough staff on each shift so that people living in the home are not rushed and their independence is maintained. Medicines are managed well so that people receive their medicines as prescribed. The activities on offer are varied so that people have enough to do and can make choices about their day so that they have some control over their lifestyle. Park House has a warm, friendly atmosphere and residents spoken with said "The home has a very homely feel" "the staff are very good." "I couldn`t fault the staff" The food on offer is good and wholesome and people spoken with said "the food is very good" "we get a good variety." A good standard of hygiene was seen throughout the home and the standard of decor was very good so that people live in a comfortable environment. Staff were seen to have a good relationship with the people in their care. All staff receive regular training to improve their skills. Park House DS0000006665.V377356.R01.S.doc Version 5.2 What has improved since the last inspection? Since the last visit five bedrooms have had the en-suites fully upgraded with new suites and flooring to give them a more modern look. What the care home could do better: The number of staff that have achieved a national vocational qualification in care, which shows that staff have had formal training to carry out their roles, needs to improve to meet the recommended fifty per cent of staff required to achieve this qualification. Recruitment procedures must be more robust so that the management know that people who are employed at the home are safe to work with elderly people. Key inspection report CARE HOMES FOR OLDER PEOPLE Park House Congleton Road Sandbach Cheshire CW11 4SP Lead Inspector Joan Adam Key Unannounced Inspection 25th August 2009 10:00 DS0000006665.V377356.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 House DS0000006665.V377356.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 House DS0000006665.V377356.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park House Address Congleton Road Sandbach Cheshire CW11 4SP 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) 01270 762259 Mr Edward Robert Venables Dale Mrs Charlotte Victoria Ellison Mr Edward Robert Venables Dale Mrs Charlotte Victoria Ellison Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Park House DS0000006665.V377356.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 only - Code PC 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 The maximum number of service users who can be accommodated is: 29 Date of last inspection 29th August 2007 Brief Description of the Service: Park House is a large detached building set in its own gardens and grounds about a mile from the centre of Sandbach. Care is provided for up to 29 older people. Park House is a two-storey building, and access between floors is via stairs and a shaft lift. The home has 27 single bedrooms and one double bedroom. All of the bedrooms have en suite facilities. The home offers three main lounges and a dining room on the ground floor, and a sun room on the first floor overlooking the courtyard. Gardens are set in two acres of land. Park House DS0000006665.V377356.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The overall quality rating for this service is two stars. This means that the people who use the service experience good quality outcomes. We made an unannounced visit to Park House on 25th and 28th of August 2009. This was to assess if peoples needs were being met at the home. Before the visit the manager was asked to complete an Annual Quality Assessment Audit (AQAA) to give us up to date information about the home. During the visit we spoke to the management at the home, some staff members, some residents and some relatives. Some of the comments we received is detailed in this report. Feedback was given to the managers/proprietors on the second day of the visit. What the service does well: Each person who comes to live at Park house is assessed so that they know their needs can be met. All the people who live at Park House have an individual care plan in place so that staff know what they need to do for each person. There is enough staff on each shift so that people living in the home are not rushed and their independence is maintained. Medicines are managed well so that people receive their medicines as prescribed. The activities on offer are varied so that people have enough to do and can make choices about their day so that they have some control over their lifestyle. Park House has a warm, friendly atmosphere and residents spoken with said “The home has a very homely feel” “the staff are very good. “I couldn’t fault the staff” The food on offer is good and wholesome and people spoken with said “the food is very good “we get a good variety. A good standard of hygiene was seen throughout the home and the standard of decor was very good so that people live in a comfortable environment. Staff were seen to have a good relationship with the people in their care. All staff receive regular training to improve their skills. Park House DS0000006665.V377356.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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 House DS0000006665.V377356.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 Park House DS0000006665.V377356.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3 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 living at Park House have their needs assessed before they live at the home so that they know their needs can be met there. EVIDENCE: The AQAA told us that “detailed pre-admission assessments take place. “ When we visited the home we found that this was true. We looked at care records of two people who were recently admitted to the home. A full assessment of their needs had been obtained from them and their families so that a good picture of the person is given to staff. This gives information for a care plan to be written. The home does not provide intermediate care so this standard was not looked at. Park House DS0000006665.V377356.R01.S.doc Version 5.2 Page 9 Park House DS0000006665.V377356.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 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. People who live at Park House have their health, personal and social needs met in a dignified way. EVIDENCE: The AQAA stated that “detailed care plans and assessments in place to ensure every service users individual needs are met” We looked at care plans for four people living at the home. These were found to contain enough detail to give guidance for care staff to know what to do to meet the persons’ needs. However, these care plans are not person centred and need to be improved to give more information to any new staff who work at the home. The senior staff are working on new documentation to make a more person centred care plan so that more information is in place for people with more complex needs. A moving and handling assessment had been completed on each resident so that staff would know how to move them safely. Park House DS0000006665.V377356.R01.S.doc Version 5.2 Page 11 Choices were recorded such as when they liked to get up, where they spent their day and how their spiritual needs were met. Visits from other health care professionals such as G.Ps and district nurses were recorded so staff would know when these visits had taken place and why. Care plans had been evaluated on monthly basis and these were detailed and gave an idea of what had happened to the person that month. The atmosphere in the home was warm and welcoming and all staff were seen to be friendly and appeared to have good relationships with the people in their care. Some staff have worked at the home for a number of years. When spoken with staff were aware of peoples needs and their likes and dislikes. People spoken with said “it is a very nice home “the staff are wonderful. One relative spoken with said “we couldn’t fault it “My relative is treated with respect” Daily records were detailed and gave a picture of how the person spent their day. Medication management was looked at. Medication administration sheets had been completed so that staff would know when medications had been administered. Medicines received in to the home were recorded each month. The home uses a blister pack so that it is easy to see if medicines have been given out at the right time. Controlled drugs were signed for by two staff members and checked each month, however, these drugs need to be checked on a daily basis by two staff members and a running total recorded so that any errors could be identified and dealt with immediately. This was discussed with the manager/proprietor and senior staff members who stated that this would be put in to place immediately. Park House DS0000006665.V377356.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 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. People who live at Park house are able to take part in a range of activities and mealtimes were a positive experience. EVIDENCE: The home does not have an activities co-ordinator in post at present. This post has been advertised and a new staff member will be commencing in September. We found a varied activities programme was on offer each day for people to join in if they wish and staff are completing the activities programme on a daily basis. When we asked people they said could choose to join in or not. The manager/proprietor said that the range of activities on offer would increase when the new staff member was in post. Choices are recorded in the care plan such as how the people live in the home like to spend their day. There is a varied menu on offer at Park House and the lunch looked good and appetising. People spoken with said “the food is really good we have a good choice of food “the cakes are all home-made.” Some vegetables have been grown in the garden by the proprietor. Park House DS0000006665.V377356.R01.S.doc Version 5.2 Page 13 Park House DS0000006665.V377356.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 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 who live at Park House are confident that their complaints are listened to and staff have received training so that they know what to do to protect people. EVIDENCE: People spoken with said that they knew how to make a complaint. “I would speak to the manager, but I have no complaints “People could be confident that their complaints would be listened to. CQC has received one complaint since the last visit and this has been fully investigated by the home using their complaints procedure. The home had policies and procedures on the prevention of abuse and whistle blowing. The safeguarding procedure is how the local council and other agencies respond to allegations of abuse against vulnerable people. Staff have received training about safeguarding people from abuse so that they know how to deal with any incident or suspicion of abuse. Park House DS0000006665.V377356.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service live in a well maintained environment, which is equipped to meet their needs. EVIDENCE: We walked round the home and looked in all communal areas, bathrooms and some bedrooms. People who live at the home were spoken with and they said that the home is “always spotlessly clean. The decor of the home was of a high standard and each bedroom was well personalised. The home was cleaned to a high standard and there were no unpleasant odours. New carpets have Park House DS0000006665.V377356.R01.S.doc Version 5.2 Page 16 been laid on all landings. The alarm system and the nurse call system have been rewired to ensure it is working properly. The courtyard near to the kitchen has been improved to give a better outlook to this area of the garden. The garden is enclosed, very well maintained and walks around the garden on a daily basis, weather permitting, are very popular with people living there. Park House DS0000006665.V377356.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive care and support from skilled staff that they like. EVIDENCE: We found that staff are supplied in sufficient numbers to meet people’s needs and people who live in the home said they thought that there was enough staff on duty on each shift. People said that if they needed help staff would come to them quickly if they rang the bell. Comments such as “the staff are wonderful all the staff are very helpful Most of the staff have been working at the home for many years and have good relationships with the people in their care. We saw that only three of the staff working in the home have achieved a national vocational qualification in care which shows that three staff have had formal training to carry out their roles. Seven staff have recently been enrolled to undertake the course. This number needs to improve to meet the recommended fifty per cent of staff required to achieve this qualification. We saw staff training is on-going and that all staff have received mandatory training in key subjects. This means that staff have been given the skills to promote peoples health and welfare. Several courses have been undertaken Park House DS0000006665.V377356.R01.S.doc Version 5.2 Page 18 by staff since the last visit such as infection control, hand hygiene, diabetic awareness. Training is planned for nutrition management and pressure sore awareness. We saw staff files for four people who have recently commenced work at the home. Three staff files contained all the appropriate checks carried out before staff commenced work. However, one file showed that the Criminal Record Bureau (CRB) check in place had been obtained from the previous place of work. These checks are not transferable from one service to another. The manager/proprietors agreed to apply for the CRB immediately and have the staff member working under supervision until this was returned so that they were sure that all staff are safe to work with elderly people. Two references had been obtained for this staff member. Park House DS0000006665.V377356.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 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 is well managed and the views of people who live there are obtained EVIDENCE: The managers/proprietors’ have been running the home for a number of years and are registered with CQC (previously CSCI). They are at the home on a daily basis and are very “hands on.” A senior care manager has obtained NVQ level four in care and management. Park House DS0000006665.V377356.R01.S.doc Version 5.2 Page 20 Staff, people who live at the home and relatives all spoke highly of them and felt they were supportive and approachable. One visitor spoken with said “The home has a homely atmosphere which makes people feel comfortable.” The home has a residents committee run by the residents themselves. Regular senior staff meetings take place to discuss all areas of care planning and the running of the home and minutes are taken. Regular fire drills and staff training sessions are held to make sure staff know what to do in case of fire. The AQQA recorded that the equipment in the home had been checked and serviced to make sure that it continues to be safe and effective. The home does not have responsibility for residents’ monies. Park House DS0000006665.V377356.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X N/A X X 3 Park House DS0000006665.V377356.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. 1 Standard OP29 Regulation 19 Requirement A Criminal Records Bureau check must be applied for before any staff commences work at the home. So that the home knows that know they are safe to work with elderly people. Timescale for action 30/09/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Park House DS0000006665.V377356.R01.S.doc Version 5.2 Page 23 Care Quality Commission North West Region 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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