Care Home: Park House

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What the care home does well We found good evidence to show that the manager and staff team are totally committed to providing good care and attention to people who live at Park House. People and their relatives said they had good information about Park House, and the manager kept them well informed. People said they were very satisfied with the way staff support them in their health care and personal care needs. They said staff were friendly and helpful, and "couldn`t do enough to help".People, and their relatives, said the social opportunities were excellent. And the manager, Mrs Crabtree, went to great lengths to provide celebrations, enjoyable outings, and entertainment. Mrs Crabtree encouraged relatives to join in celebrations and festive activities. One relative described it as "a real welcome". The standard of food was excellent, and the cook and staff went to a lot of effort to make mealtimes dignified, pleasant and social events. The home places a lot of importance on making sure people have good fresh and nutritious food. People were highly satisfied with the environment; they said they found it comfortable, clean and homely. The manager and staff went to a lot of effort to make sure people lived in pleasant and tasteful surroundings. One person described it as "my home, just as I like it". People said they knew they could complain if they needed to. They said they could approach staff and the manager, Mrs Crabtree. A relative said Mrs Crabtree encourages people to say if they need anything, or if they are not happy about something. People said the staff team were very committed and relatives said the manager is always available and watches over the care of people very closely. Staff have access to training, and the manager has made arrangements to update some staff training in the near future. This helps to make sure people get safe and consistent care. Park House has health and safety procedures to make the home a safe place to live in. The home carries out maintenance checks to make sure equipment and services are safe and well maintained. What has improved since the last inspection? Staff training has improved since the last inspection. People said they are looking forward to a new treatment room that the providers are building. Park House has refurbished a bathroom; this makes it easier for people to access the bath. And they now have under floor heating. What the care home could do better: There are three main areas that the home needs to improve to make sure people continue to have good care and are safe from harm.Most important is that the manager and staff improve the medication system and make sure they always follow safe practices. (Staff did start to follow some safer practices during our visit). The manager needs to do a regular audit to make sure the system is always safe and clean. The manager needs to make sure people have a criminal record bureau check, before they start work, this helps make sure people get care from suitable staff. People`s assessments and care-plans need to improve. We have identified this in the last three inspections. This is important because people need a record of their care needs and what action the staff take. This will help make sure the providers can show that they have given people appropriate and safe care. The providers have failed to meet requirements we have issued on previous inspections. This is disappointing and does not reflect the homes general high standards. We have issued Park House with these requirements because they need to improve assessments, care plans and medication practices in order to keep people safe. If the providers do not take action this is likely to affect their ratings in the future, and the commission may decide to take further action. In addition to this the home needs to improve the following areas to make sure people continue to get good care and support: The manager and senior carers should attend the local authority Safeguarding Adult training, so that they understand local procedures better. This will help them take the right action if some one is at risk of harm. The manager needs to make sure the induction package meets with Sector Skills Council national standards; this will help make sure new staff have current and safe practice information. The providers need to put better quality assurance checks in place. This would help make sure, for example, that staff manage people`s assessments, care plans and medication well.DS0000018273.V351794.R01.S.docVersion 5.2Page 8 CARE HOMES FOR OLDER PEOPLE Park House Worsbrough Road Worsbrough Village Barnsley South Yorkshire S70 5LW Lead Inspector Mrs Sue Stephens Key Unannounced Inspection 6th November 2007 09:50 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000018273.V351794.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000018273.V351794.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park House Address Worsbrough Road Worsbrough Village Barnsley South Yorkshire S70 5LW 01226 281228 F/P 01226 281228 none 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) Mr Paul Crabtree Mrs Gloria Crabtree Mrs Gloria Crabtree Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places DS0000018273.V351794.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd November 2006 Brief Description of the Service: Park House is a stone built property, which was originally the schoolhouse to the village school. The home has been adapted and extended while maintaining many of its original features in order to create a personal care home with accommodation for 20 elderly persons. It occupies a central position in the conservation village of Worsborough and there is one acre of well-maintained gardens, including a small orchard. The home is adjacent to Worsborough Country Park and is in close proximity to the Parish Church of Saint Marys and the local pub. Main bus routes are close by and the home is about three miles from Barnsley town centre and two miles from junction 36 of the M1 motorway. Accommodation is on two floors, serviced by a passenger lift. There are 12 single and four double bedrooms, two lounges and one dining room. The home has a car park at the rear and side of the building. The manager gave the Commission for Social Care Inspection information about the home’s fees and charges on 19 November 2007. The fees range from £372.50 to £375.00 per week. This depends on the size of the room and the residents’ individual needs. Their charges include hairdressing, chiropodist, toiletries and transport. These charges are variable; the manager can provide more information about this. People who are interested in Park House can get information by contacting the manager. The home will also provide a copy of the statement of purpose and the latest inspection report. DS0000018273.V351794.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was unannounced; it took place between 9:50 am and 14:30 pm on 06 November 2007. During the visit the inspector spent time talking to people who live there, and observed their care. The inspector also spoke to visitors, relatives and staff. The manager was off duty at the time of the visit. During the visit the inspector looked at the environment, and made observations on the staffs’ manner and attitude towards people. She checked samples of documents that related to people’s care and safety. These included four care plans, medication records, and a sample of health and safety records. The inspectors looked at other information before visiting the home, this included evidence from the last key inspection, surveys, and the homes Annual Quality Assurance Assessment (AQAA). An AQAA is information the commission ask services to provide once a year to show how the provider thinks the home is performing. Five people who live at Park House and three relatives responded to our surveys. This was a key inspection where the inspectors checked all the key standards. The inspector would like to thank the people who live at the home, visitors, managers and staff, for their warm welcome and help in this inspection. What the service does well: We found good evidence to show that the manager and staff team are totally committed to providing good care and attention to people who live at Park House. People and their relatives said they had good information about Park House, and the manager kept them well informed. People said they were very satisfied with the way staff support them in their health care and personal care needs. They said staff were friendly and helpful, and “couldn’t do enough to help”. DS0000018273.V351794.R01.S.doc Version 5.2 Page 6 People, and their relatives, said the social opportunities were excellent. And the manager, Mrs Crabtree, went to great lengths to provide celebrations, enjoyable outings, and entertainment. Mrs Crabtree encouraged relatives to join in celebrations and festive activities. One relative described it as “a real welcome”. The standard of food was excellent, and the cook and staff went to a lot of effort to make mealtimes dignified, pleasant and social events. The home places a lot of importance on making sure people have good fresh and nutritious food. People were highly satisfied with the environment; they said they found it comfortable, clean and homely. The manager and staff went to a lot of effort to make sure people lived in pleasant and tasteful surroundings. One person described it as “my home, just as I like it”. People said they knew they could complain if they needed to. They said they could approach staff and the manager, Mrs Crabtree. A relative said Mrs Crabtree encourages people to say if they need anything, or if they are not happy about something. People said the staff team were very committed and relatives said the manager is always available and watches over the care of people very closely. Staff have access to training, and the manager has made arrangements to update some staff training in the near future. This helps to make sure people get safe and consistent care. Park House has health and safety procedures to make the home a safe place to live in. The home carries out maintenance checks to make sure equipment and services are safe and well maintained. What has improved since the last inspection? What they could do better: There are three main areas that the home needs to improve to make sure people continue to have good care and are safe from harm. DS0000018273.V351794.R01.S.doc Version 5.2 Page 7 Most important is that the manager and staff improve the medication system and make sure they always follow safe practices. (Staff did start to follow some safer practices during our visit). The manager needs to do a regular audit to make sure the system is always safe and clean. The manager needs to make sure people have a criminal record bureau check, before they start work, this helps make sure people get care from suitable staff. People’s assessments and care-plans need to improve. We have identified this in the last three inspections. This is important because people need a record of their care needs and what action the staff take. This will help make sure the providers can show that they have given people appropriate and safe care. The providers have failed to meet requirements we have issued on previous inspections. This is disappointing and does not reflect the homes general high standards. We have issued Park House with these requirements because they need to improve assessments, care plans and medication practices in order to keep people safe. If the providers do not take action this is likely to affect their ratings in the future, and the commission may decide to take further action. In addition to this the home needs to improve the following areas to make sure people continue to get good care and support: The manager and senior carers should attend the local authority Safeguarding Adult training, so that they understand local procedures better. This will help them take the right action if some one is at risk of harm. The manager needs to make sure the induction package meets with Sector Skills Council national standards; this will help make sure new staff have current and safe practice information. The providers need to put better quality assurance checks in place. This would help make sure, for example, that staff manage people’s assessments, care plans and medication well. DS0000018273.V351794.R01.S.doc Version 5.2 Page 8 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000018273.V351794.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 DS0000018273.V351794.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3. There was no-one receiving intermediate care at the home. People who use this service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to Park House. People have good information about the home and the fees. However; people need to have better assessments from the home; this will give produce better information about whether the home can meet their needs. EVIDENCE: One person who lives at the home told us “I stayed for two days to see, and liked it”. Another person said they heard about Park House by “word of mouth”, and liked it very much when they arrived. Relatives told us that they had good information about Park House. They said the manager, Mrs Crabtree, gave them all the information they needed before the, and their family member, chose the home. They also said they had good information about the homes fees and that Mrs Crabtree had given them a contract so they understood the homes terms and conditions. DS0000018273.V351794.R01.S.doc Version 5.2 Page 11 A relative said they have update information about fees on an annual basis, and they were very satisfied with this. Following the last inspection we gave the manager advice about producing better quality care plans. On this visit we looked at four care plans. Care staff had carried out good assessments for some people, and these identified people’s strengths and areas they needed support in. However, the assessment information for other people was incomplete, the assessment forms were in the care plans but care staff had not completed these. This means that the home did not have clear records or evidence to show that they understood and took the right action to meet people’s needs. We looked at an assessment carried out for a person new to the home. The assessment was very basic, it did not follow the homes assessment tool, and the information was not enough to give staff information about the persons needs. This means that staff might not give safe and consistent care. Or that the home might admit someone who they cannot fully care for, because they did not check out information about peoples more complex needs. We have made a requirement for the home to improve the assessment records over the past three inspections. We have assessed this outcome area as good because although the homes assessment procedures are insufficient, people told us they were satisfied with the process. If the home fails to improve the assessments this could affect their overall rating in the future. DS0000018273.V351794.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use this service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to Park House. People said they were highly satisfied with their personal and health care. To make sure people have safe medication support the home needs to make immediate improvements to the medication systems. EVIDENCE: People at the home told us they were very satisfied with their care. Relatives said they were highly satisfied and people made very positive comments in the surveys. We received a lot of good information about Park House, people told us in the surveys that they ‘always’ receive the care and support they need. People also made comments, which included: “We are well looked after” “The staff are very caring individuals” DS0000018273.V351794.R01.S.doc Version 5.2 Page 13 “Overall the care is very good” “Happy with the medical support” “What is it I like about living here? Everything!” “This place is like the jewel in the crown” When asked what the home does well one person replied “everything! I could not ask for a better home” Relatives said: “They (staff) care very well for (family member) and are good at coping with her needs” “Staff are very good at letting us know immediately if there is an emergency” “The staff are very caring and loving, they are always ready to give (family member) a hug” On the last inspection we identified that Park House needed to improve people’s care plans to make sure they had safe and accurate records about people’s personal and health care needs. The manager, Mrs Crabtree, had taken some action towards this. She had introduced a new format that covered people’s needs well. It looked at people’s strengths and had a lot of information about people’s lives, happy events and successes. Some care plans had photos from people’s younger days and this gave staff a good insight about people’s lives. This was good practice because it promoted and supported people’s dignity and respect. Some care plans were up to date, while others still needed completing. The home has a history of needing to improve care plans for all people who live at the home. Because of this we have carried forward the last requirement; it is important that all people at the home have enough information about their care in their care plans. We have made requirement over the past three inspections for the home to improve care plan records. The home’s medication systems were not safe. The practices put people at risk of harm from receiving wrong medication or from staff making errors. We found unsafe practices in storage, administration, disposal and recording. We asked the senior carers not to administer the next medication round until they had made the systems safer. They agreed to do this and we offered advice to the senior carers. By the end of the visit staff had cleaned the trolley and cupboard, separated the medication, and put aside unsuitable medication ready to return to the chemist. The carer doing the teatime medication improved some administration records to make the instruction safer and clearer. DS0000018273.V351794.R01.S.doc Version 5.2 Page 14 Staff informed the provider and manager, Mrs Crabtree, who said she had arranged with a pharmacist to come to the home, audit the medication and give staff re- training. We have required the providers to take immediate action to make sure they manage the medications systems better from now on, and keep the systems safe at all times. We have given the providers a breakdown of the areas of concern we found in more detail. We made a requirement for the home to improve medication practices on the last inspection. The outcome of this area has remained good because of the positive feedback people have given about their care. However, failure by the providers to make medication systems safe could affect the home’s overall quality rating in the future. It is important that the providers safeguard people’s health and welfare by ensuring staff follow safe medication practices. DS0000018273.V351794.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use this service experience excellent outcomes in this area. We have made this judgement using a range of evidence, including a visit to Park House. People said they were highly satisfied with their life style and the food they get at Park House. EVIDENCE: People said they had a good life at Park House. They said there was the right amount of activities and social opportunities; and that these were very interesting and they enjoyed them. People at the home, and relatives, gave examples of the events they enjoyed, and these included, trips and meals out in small groups, walks around the village, feeding the horses and enjoying the garden. People said they enjoyed the entertainers that the providers arranged for them and said there “was always something different”. The manager said they also take people, who wish to go, to church each week. They also have a monthly in-house service. Park House also puts on a live classical music concert once a month. Once a week people could enjoy a Reiki massage on their hands, people said they liked this and one person said, “It is lovely”. DS0000018273.V351794.R01.S.doc Version 5.2 Page 16 People said the manager, Mrs Crabtree, invested a lot of time and effort in providing social events, which they really enjoyed. One relative said Mrs Crabtree goes the full length to celebrate every occasion from people’s birthdays to traditional events such as Burn’s night, bonfire night and Christmas. They said the staff decorated the dining area and they put on a special menu to celebrate. When it is someone’s birthday, the person chooses the menu and their favourite foods for the day and they have an entertainer. The home had a number of small seating areas with ambient lighting or music, or just a quiet area for people to choose to sit in. They also had a choice of large-print books, magazines and music for people to choose from. People said the food at the home was excellent. The home’s statement of purpose and philosophy statement said it based its care principles around good, fresh and nutritious food. People said the choice and quality of food was very good, and that Mrs Crabtree made it very clear to them they could have anything they wanted, they just had to ask. The manager and staff went to a lot of effort to make sure people enjoyed mealtimes. The décor, furniture, settings and crockery were of good quality, and staff were very attentive when they served peoples meals. Mealtimes were sociable and relaxed. In-between meals staff offered people a variety of drinks and snacks, including homemade baking. People said they could have a drink whenever they wanted and the manager and staff encouraged this. DS0000018273.V351794.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use this service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to Park House. People can express their views and the manager and staff will take action to help people. EVIDENCE: When asked if the manager and staff listen to their concerns, one person replied, “Yes, they are marvellous, but I have nothing to complain about”. People and relatives said the manager had made it very clear to them that they must say so if they are not happy about anything. People said they were very confident they could tell staff or the manager if they wanted to complain. The homes complaints procedure was on display near the entrance, this was clear and easy to see. The home had adult protection procedures, however, not all staff had had training to demonstrate that they understood safeguarding adult procedures (adult protection). The manager told us she had arranged some training for the near future. The home had dealt with one adult protection inquiry. The manager had attended meetings, provided information and worked with the relevant authorities to safeguard the individual. However, we identified, during this time, that the manager and staff needed to understand safeguarding adult DS0000018273.V351794.R01.S.doc Version 5.2 Page 18 procedures better. And we recommended to the manager that she, and all staff access the free training from the local social service authority. The manager had not followed up this recommendation by the time of our visit; however we acknowledge that the manager has sought other training. We still recommend that at least the manager and senior carers attend local authority training to help them understand local procedures better. This will give people better safeguards to protect them from risk of harm or abuse. DS0000018273.V351794.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23 and 26 People who use this service experience excellent outcomes in this area. We have made this judgement using a range of evidence, including a visit to Park House. People live in a clean, comfortable and pleasing environment. EVIDENCE: People told us they were highly satisfied with homes environment. They said the furniture and furnishings were comfortable and met their needs. They said they appreciated the décor; and a relative said the manager goes to a lot of effort to make the place homely and interesting. They said the manager puts a lot of emphasis on pictures, ornaments, displays and lighting for people to enjoy. There are examples of this throughout the home. People made comments, which included: “Excellent surrounding and able to go outside in the summer” DS0000018273.V351794.R01.S.doc Version 5.2 Page 20 “They provide a homely environment” “It is just like their own home”. People said their bedrooms were comfortable, they had all the things they needed and one person said “Its just the way I like it”. The home was clean and free from offensive odours. The providers had recently refurbished a bathroom to give people better access to the bath. And the home was in the process of building an extension for a medical room. People said the manager had consulted them about this and they thought it was a good idea and looked forward to its completion. DS0000018273.V351794.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use this service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to Park House. People are satisfied that the staff team gives them good care and support, and they know how to meet peoples’ needs. Park House needs to follow better recruitment procedures to make sure they continue to employ suitable staff and keep people safe. EVIDENCE: People, and relatives, said about the staff, “They are marvellous” “Yes, they are around when we need them” “Staff are caring and loving” “They seem to have the right mix of skills and experience” “We have not had cause to question or complain about them” “The carers go way above their line of duty” People said they were very satisfied with the way staff offer them help and support. Most staff had a National Vocational Qualification in care at level 2 or above. And the manager had arranged training to suit people’s needs. For example DS0000018273.V351794.R01.S.doc Version 5.2 Page 22 the manager had arranged for staff to attend a nutritional workshop. This is good practice because good nutrition is significant to people’s health, welfare and comfort. Staff had also attended training on ‘managing challenging behaviour in the care home’. One member of staff said the training event was very good and had helped them think about their care approaches and how to handle difficult situations better. We could not access staff recruitment records because the manager was off duty. The manager provided a sample of these after our visit. Two staff confirmed that they did not have a Criminal Record Bureau check done by the home before they started work there. This does not meet with regulations, which requires new employees to have a new CRB when they start work with new employees. Staff have an induction, and this gives them information about the home’s working policies and guidelines. We saw a fresh induction document but not one completed by a staff member. We found no evidence to show that Park House kept its induction package up to date with the National Skills for Care Induction Standards. We recommend that the manager should do this to make sure staff have inductions in line with current national good working practices. We have assessed this outcome area as good because we have good feedback from people. They said they were happy with the staff team’s approach, manner and skills. However, when the home fails to follow safe recruitment procedures it does put people at risk. If the Park House fails to improve the recruitment practices (mainly criminal record bureau checks) it is likely to affect the overall rating in the future. DS0000018273.V351794.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People who use this service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to Park House. People live in a well managed home. The homes safe working practices help protect people from accidents and injuries. EVIDENCE: People, who live at Park House, and relatives, spoke very highly of the manager. They said Mrs Crabtree was very attentive to everyone’s needs. She made visitors very welcome and spent a lot of time observing and supervising people’s care. One person said, “I can have anything I want, we just ask Mrs Crabtree and she will get it” DS0000018273.V351794.R01.S.doc Version 5.2 Page 24 And a relative said “we are very satisfied, Mrs Crabtree has got her finger on the pulse”. People said they were very satisfied with the quality of the home and their care. However, we found little evidence of quality assurance checks, for example monthly visit reports and written quality audits. The manager told us, after our visit, that the homes administrator had left in March. They had now appointed a new staff member to help with improving the assessments, care plans, and medication. We acknowledge that the manager had completed an annual quality audit assessment and that this forms some part of the homes quality audits. We recommend that the manager review this to make sure the home has better records of its successes and identified areas for improvement. The providers have not met our requirements relating to peoples’ assessments, care plans and medication following this and previous inspections. This shows that the providers have not taken enough action to improve these practices. And this puts the quality and safety of peoples care at risk. If the home does not improve these areas this may affect their quality ratings in the future. Park House encourages people to look after their own monies where this is possible. Where people need support Park House offers safekeeping for monies and valuables. Records show that the manager monitors this well and includes receipts and double signatures from staff to show deposits and withdrawals. Staff have training in safe working practices. Such as, fire safety, food hygiene, moving and handling and first aid. The manager told us, in a letter after our visit, that some staff were due to up-date their training. And the manager had organised several training days to cover this. The manager confirmed in the homes AQAA (annual quality assurance assessment sent to us before our visit) that the homes maintenance and safety checks were in place and up to date. For example the maintenance of the homes lift, hoists and water systems. DS0000018273.V351794.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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 4 X X X 4 X X 4 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 DS0000018273.V351794.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes 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 OP3 Regulation 14 Requirement Plans of care must be based on the outcomes of each resident’s needs assessments. The assessments must include relevant detail such as the details as set out in standard 3 of the National Minimum Standards. This will safeguard people and help make sure their care is safe and consistent. Previous action dates 30/05/05, 30/04/06 and 31/01/07 2. OP7 15,17 Residents’ records must include all the information in schedule 3 of the Care Homes Regulations 2001, and the home must be regularly review them to reflect the changing needs of the residents. Previous action date 30/06/05, 30/04/06 and 31/01/07 DS0000018273.V351794.R01.S.doc Version 5.2 Page 27 Timescale for action 31/01/08 31/01/08 Each resident must have a plan of care that identifies their needs and outlines the action staff must take to meet those needs. 3. OP9 13 The home must have a record of the purpose of the residents’ medication. The home must check with the pharmacist what homely remedies are safe for each resident. Previous action date 31/01/07 4. OP9 13.2 Immediate requirement To make sure people are not put at risk of medication errors the providers must take the following action: Make sure the medication storage, administration, recording, and disposal practices follow legislation and good practice guidelines. (For example the Care home regulations 2001, The Medicines Act 1968 and the Royal Pharmaceutical Society guidelines) The providers must make sure they check the medication systems and staff practices regularly to ensure staff follow safe and consistent practices 5. OP29 19 Schedule 2 The registered providers must not allow staff to work with or have contact with people who live at the home unless the providers have carried out a POVA and CRB check first. DS0000018273.V351794.R01.S.doc 31/12/07 06/11/07 31/12/07 Version 5.2 Page 28 (Protection of Vulnerable Adults list and Criminal Record Bureau check). This regulation helps to protect people from receiving care from unsuitable staff who may put vulnerable people’s safety and welfare at risk. 6. OP33 43 The providers must take action to meet the requirements issued by the Commission for Social Care Inspection We issue requirements where we identify people’s welfare is, or could be, at risk because of the homes practices. In the past the providers have failed to meet some requirements, this could affect their overall ratings in the future. See standards 3, 7 and 9. 31/01/08 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 OP18 Good Practice Recommendations We strongly recommend that the manager and senior care staff attend the local authorities free safeguarding adult training events. This will give the manager and staff better knowledge and skills to deal with local safeguarding adults procedures. This will benefit people who live at the home because they will have support from staff who have good knowledge about how to prevent abuse and what to do if some one is at risk. DS0000018273.V351794.R01.S.doc Version 5.2 Page 29 2. OP30 The homes induction package should be linked to National Skills for Care Induction Standards. This will help make sure people continue to receive safe and consistent support . We strongly recommend that the providers review their quality assurance systems to make sure they take positive action to develop and maintain areas that need improvement. This will benefit people who use the service and help make sure they continue to receive good quality care. 3. OP33 DS0000018273.V351794.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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