Care Home: Park House

Similar services:

• Fairfields Country Rest Home
• Poldhu
• Queensmount
• Trevaylor Manor
• Didsbury Court Rest Home
• Belma
• Hunters Care Centre
• Manor Lodge

What the care home does well Individuals admitted to the home have their care needs assessed prior to their admission. Clear assessment records are kept for individuals and care plans are developed, which guide staff how to meet the person`s needs. People spoken with during the inspection reported that staff are friendly and helpful toward them. "Nothing seems too much trouble for them". People who visit the home received a warm welcome from the staff. Visiting times are flexible. One health professional when asked what the home does well commented " Manages clients with in their client group effectively. Some very capable staff who care for some complex individuals" The manager operates a robust recruitment and selection process, which ensures that staff working with people living at Park House are suitable. This process protects people from unsuitable staff. The staff working at Park house are sensitive to the needs of the people they care for and have their best interests at heart. Comments received included:- "A very nice place","I think they are all looked after very well" What has improved since the last inspection? A new filing cabinet now contains care planning record, this was easily available in the dining room for staff working at the home. The "as required" medication information for individual people had been recorded clearly. This should protect people and ensure they receive the medication they need. The way people`s laundry was managed has changed. Each person has an individual basket where their clothes are stored after laundry until they are returned to them. This should ensure that people have their own clothes returned to them after laundry. What the care home could do better: The garden area was not safe for people with dementia to use because the garden area was not secure enough to enable people to use it independently if they are able. Although some rooms have been refurbished and redecorated; not all people`s rooms` individual room have the same standard. This means that the quality of the decor and carpets was dependent on, which room the person occupied in the home. Controlled drugs had not been returned to the pharmacy when they were no longer required by the person they were prescribed for. Records of returned medication were not available. This did not provide a clear audit trail for medication stock control management. And did not ensure that the risk of people receiving medication they no longer require was reduced. Although peoples care plans clearly stated the reasons for restricting a person going out side the home unaccompanied. Risk assessments for people who want to go outside the home had not been completed with the reasons they were being restricted . This may mean that people are not given sufficient opportunity to go out side the home. Not all the individual rooms entered were fresh, clean and free from odour. Two rooms had a strong unpleasant smell and one had soiling on the furniture covers. This means those people occupying those rooms did not have a room that was being kept fresh and clean for them at all times. The lack of a designated cook and domestic may mean that staff who provide care have their time taken up with domestic tasks and have less time to spend with people living at Park House. The results of an annual quality audit of the home had not been provided for people who use the service and the Commission. This may mean the Commission and people who use the service are not aware of how the home was being run in the interests of people who live there. Key inspection report Care homes for older people Name: Address: Park House 7 Manor Road St Marychurch Torquay Devon TQ1 3JX     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: Rachel Proctor     Date: 1 1 0 9 2 0 0 9 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 29 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) 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 Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Park House 7 Manor Road St Marychurch Torquay Devon TQ1 3JX 01803314897 01803323784 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Diane Winifred Bennett,Mr Christopher Norman Bennett care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The home may accommodate up to 2 Service Users over 60 years. Date of last inspection Brief description of the care home Park House is a large detached property with pleasant gardens situated in a quiet residential area on the outskirts of Torquay. The home is close to local amenities. It is registered to provide care for older people including those with physical disabilities and/or dementia, and up to two people aged over 60 years. Fifteen of the rooms have en-suite facilities. There are two spacious lounges and a separate dining room. Part of the dining room was being used as the office. A shaft lift provides access to the upper floor. At the time of this inspection fees ranged between #333 and #400 per week Care Homes for Older People Page 4 of 29 Over 65 21 21 21 0 0 0 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: This was an unannounced inspection, which took placed on the 10th and 12th of September 2009. Two people had their care followed during the inspection. This involved looking at plans of care, seeing the rooms the people occupied and speaking with them in private where possible. A selection of records relating to management and care provided were reviewed during the inspection. A tour of the home was completed; this included communal areas and individual peoples rooms. Four people living at home and four members of staff were spoken with during the inspection. Staff were also observed providing care for people. Anonymous survey forms were received from two people living at the home and three staff. This provided us with information about living and working at Park House. Information from the visit to the home and some comments made during the inspection and in the anonymous survey forms have been included in this inspection report. Care Homes for Older People Page 5 of 29 What the care home does well: What has improved since the last inspection? What they could do better: The garden area was not safe for people with dementia to use because the garden area was not secure enough to enable people to use it independently if they are able. Although some rooms have been refurbished and redecorated; not all peoples rooms individual room have the same standard. This means that the quality of the decor and carpets was dependent on, which room the person occupied in the home. Controlled drugs had not been returned to the pharmacy when they were no longer required by the person they were prescribed for. Records of returned medication were not available. This did not provide a clear audit trail for medication stock control management. And did not ensure that the risk of people receiving medication they no longer require was reduced. Although peoples care plans clearly stated the reasons for restricting a person going out side the home unaccompanied. Risk assessments for people who want to go outside the home had not been completed with the reasons they were being restricted Care Homes for Older People Page 6 of 29 . This may mean that people are not given sufficient opportunity to go out side the home. Not all the individual rooms entered were fresh, clean and free from odour. Two rooms had a strong unpleasant smell and one had soiling on the furniture covers. This means those people occupying those rooms did not have a room that was being kept fresh and clean for them at all times. The lack of a designated cook and domestic may mean that staff who provide care have their time taken up with domestic tasks and have less time to spend with people living at Park House. The results of an annual quality audit of the home had not been provided for people who use the service and the Commission. This may mean the Commission and people who use the service are not aware of how the home was being run in the interests of people who live there. 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 7 of 29 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 8 of 29 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. People are given sufficient information about Park House and the services they provide to make an informed choice as to whether the home can meet their needs. The way individual peoples care needs are assessed and recorded should ensure that people receive the care they need. Evidence: The manager advised that the statement of purpose was provided for new people admitted to the home and was available on request. Two visitors spoken with during the inspection said they had been given information about the home and its services and were aware that the homes statement of purpose was available for them on request. Three of the nineteen people living at Park House at the time of this inspection had Care Homes for Older People Page 9 of 29 Evidence: their care followed. This involved looking at their care planning information. Speaking to the person where possible and visiting the room they occupied in the home. They had an assessment of need completed by the manager prior to their admission to the home. The manager uses an assessment template, which prompts the assessment process to cover peoples health and personal care needs as well as personal preferences. Two of the people had care plans, which had been developed from their assessment of need. One person who had been at the home for less than a month had a copy of the care managers care plan assessment with their care plan information. The assessment indicated that they were at risk of wandering. Information from a previous care home had also been provided. The manager advised that they were getting to know the persons care needs and would be up dating their care plan to reflect this. This person was spoken with during the inspection. They said they were happy with the room they had been provided with and the food was good. They also said staff were very helpful to them. Park House does not provide intermediate care. Care Homes for Older People Page 10 of 29 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. The way care plan information was recorded for individual people living at Park House should ensure they receive the health and personal care they need. And staff understand the needs of the people they care for. Information regarding controlled drug did not ensure controlled drug medication records of returns are completed as required. Keeping accurate records ensures controlled drug medication will be monitored and disposed of safely. The risk of people receiving medication they no longer require will be reduced. And the risk of misuse of a controlled drug will be prevented. People living at Park House are treated with respected by the staff team who care for them. The things that are important to them are taken into account when their care is planned. Evidence: The people whose care was followed all had care plans in place, which had been Care Homes for Older People Page 11 of 29 Evidence: developed from their assessment of need. The people whose care was followed had a monthly record of care plan reviews. The manager confirmed that all the people living at Park House have their care plan reviewed monthly or sooner if their care needs change. The care planning system uses a template, which lists possible care needs. The person completing the template identifies the care need for the individual by ticking the relevant section. These templates cover health; personal, emotional and social care needs for the individual. The three plans of care viewed had all the sections in the care plan completed and up dated with a review date. In addition to this one person whose care was followed had a person centred care plan. The manager advised that these were being introduced for all the people in the home. She advised that only seven of the nineteen people had still to have a person centred care plan completed. The manager advised that these were being introduced in addition to the care plans already used to enable the persons personal preferences and care needs to be reflected in more detail. These should ensure that staff are able to understand what was important to he person and how their care should be delivered to meet their expectations. The manager has continued to use a care plan sheet, which was kept in individual bedrooms. These contained information about the basic care needs for the individual, and space for staff to sign this when the care task had been completed. These included cream to be applied to the persons skin. The way the care plan information was stored has changed since our last inspection. Care plans are now kept in a lockable filing cabinet in the dining room. This means that all the staff on duty each shift can have access to peoples care plans. This should ensure staff have access to information that will enable them to provide continuity of care for people. Risk assessments continue to be an integral part of the care planning process. These risk assessment included manual handling, nutrition, pressure sore risk and risk of falls. Each person whose care was followed had completed risk assessments, which had been up dated when changes had occurred. The home has recently introduced a puppy to the home for people living there. Risk assessments regarding risk of falls the puppy could cause for the individuals had been completed. However although one person whose care was followed had information in their plan of care regarding why they were unable to leave the home unaccompanied a risk assessment had not been completed for this. Medication was being stored in a locked cupboard; separate storage had been provided for controlled drugs. The manager advised that one of the people living at Care Homes for Older People Page 12 of 29 Evidence: Park House at the time required controlled drugs. The controlled drug record was available for inspection. This had been completed to show the name and dose of the drug and the person prescribed for. Two staff members had signed this record when the medication was given. However controlled drugs for people no longer at the home were still being stored. When this was pointed out to the manger she organised the return to pharmacy and had completed the controlled drug book for return of the medication. There was a system in place for returning medication no longer required to the pharmacy. However the returns record book was not available during the inspection. The manager advised that the returns drug book goes to the pharmacy when medication is returned and the pharmacy send it back when they deliver medication for people. This means the manager did not have a clear audit of how returns were being managed in the home. The manager purchased a carbon copy book which she advised would be used for all returned medication in future. This would allow the record of returns to be sent to the pharmacy and the home to retain a copy. The records of medication administration were checked for the three people whose care was followed. These had been completed as required. One person was managing their own medication. A risk assessment for medication management had been completed by the manager. However she advised that the person had refused to sign the assessment. This was documented on the risk assessment in the persons plan of care. The manager confirmed that other people in the home were unable to manage their own medication. People who were spoken with during the inspection said staff were very helpful and friendly and understood what they needed. Staff observed providing care for people were doing so in a friendly supportive way that valued the person as an individual. Staff were seen to knock on individuals room doors before entering their room. People were being addressed by their preferred name, which had been recorded in their plan of care. Two people who had formed a friendship since their admission to the home were spoken with in privacy. They said staff are very good and help them with the things they needed help with. The manager explained how peoples personal laundry was being managed in the home. She confirmed that no individual staff member was responsible for laundry. She advised that each member of staff puts washing in the washing machine or drier during their shifts. Staff are also responsible for ensuring peoples clothes are returned to them. Since our last inspection the way peoples clothes are stored after they have been laundered had changed. Each person had a basket where their person items of Care Homes for Older People Page 13 of 29 Evidence: clothing were stored prior to them being returned. This should ensure people have their own clothes returned to them. Two relatives spoken with said their relative was always dressed as they know they liked and praised the staff for their care and attention. Care Homes for Older People Page 14 of 29 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. People who live at Park House are given the opportunity and encouragement to make choices about their day to day lives. Staff ensure that people have food they like to eat and it meets their dietary requirements. However not having a dedicated cook may mean that care staff do not have as much time to spend with people living in the home. Evidence: The routines of the home enabled people to make choices of how they spent their day. Some people chose to stay in their own rooms others were in one of the communal lounges. A list of the activities on a four week rota was displayed in the lounge. This showed that people have access to a variety of entertainment. Staff provided activities some days other days visiting entertainer provide the activities. On the day of the inspection a visiting entertainer was provided. They said they visit the home once a fortnight in the afternoon and provide varied activities for people. The manager advised that the people living at Park House appeared to really enjoy this entertainers sessions. Two people living in the home had brought their dogs with them when they moved in. Care Homes for Older People Page 15 of 29 Evidence: A member of staff helped each of these people to take their dogs for a walk during the second day of the inspection. In addition to the two dogs people had brought with them the home manager had provided a puppy who lives permanently at the home. The people living at Park House appeared to be enjoying having the puppy around. Visitors were coming and going through out the two days of this inspection. They were seeing people in the privacy of their own rooms or in one of the communal areas. One person living at the home has their own mobility scooter, which enables them to go outside the home. The manager confirmed that risk assessments had been completed, which showed the person was able to go out unattended if they wished. Peoples rooms entered during the inspection had been personalised with items of their choice. This included photographs and small items of furniture. One person spoken with had brought a book of poems that they had contributed to. The manager confirmed that people who are able are encouraged to manage their own financial affairs for as long as possible. Where this had not been possible an advocate had been appointed. Information was provided for one person whose care was followed in their care information that showed the person had some one to manage their financial affairs. The lunchtime meal was attractively presented and nutritionally balanced. The manager advised that if a person did not like what was on offer an alternative would be made for them. This mealtime appeared unhurried with people eating their meals at their own pace. The manager advised that those people that needed assistance to eat had their meals at the second lunchtime sitting. Staff observed assisting people were doing so in a friendly supportive way. The manager advised that staff are aware of individual peoples likes and dislikes for food. Where preferences or dislikes were known these were recorded in the persons plan of care. Examples of this were seen. Three people spoken with said they preferred to eat their meals in their own rooms. Comments received from people living at Park House included; Welcome people with their pets. Listen to their residents. Fresh meals every day. The manager advised that the cook, cleaner and one of their carers had left at the same time five weeks earlier. She said that although they had advertised a new cook and cleaner had still to be appointed. The interim arrangements were that staff on duty prepared and cooked the meals for people on a daily basis. Three staff were on duty during the morning of the inspection. The manager advised that some staff were working extra hours to cover the short fall until new staff had been appointed. She also advised that she and the owner cooked meals for people. Staff spoken with commented that they worked the extra shifts to enable the people who lived at Park Care Homes for Older People Page 16 of 29 Evidence: House to be cared for by staff who knew them well. One commenting that, we are a team and we all work together to ensure our residents are happy. Although the current staff arrangements are not ideal peoples needs were being met and people told us they liked the food they had and there was choice. The manager confirmed that this was a temporary arrangement until a new cook could be appointed. Care Homes for Older People Page 17 of 29 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. People who live at Park House can feel confident that their concerns will be listen to by staff and treated seriously. There are sufficiently robust systems in place to protect people from abuse. Evidence: The people who were asked said they knew who to speak to if they had any concerns. The anonymous surveys returned prior to the inspection indicated that people and or their relatives knew who to speak to if they had any concerns. The complaints policy was available with the Statement of Purpose and Service Users Guide. The manager provided the record of concerns and or complaints; this included the date and persons name. She advised that the full details of the complaint and any action taken were recorded in individual peoples care plans. And this would show the actions taken to address the issues raised. The manager advised that no complaints had been received since the last inspection. She further commented that if a concern was raised this was dealt with as it occurred. Visitors spoken with during the inspection and people living at the home indicated that staff are friendly and approachable. All indicated they knew who to speak to if they had any concerns. Two commenting that the staff at the home were very good and seemed to have the persons interests at heart. Care Homes for Older People Page 18 of 29 Evidence: Policies and procedures are in place for protecting people from abuse. And information about the local arrangements for adult protection were available for staff. The manager advised that work books are used to help staff understand the implication for their work regarding adult protection. Completed adult protection Workbooks were seen in two staff files viewed. Pre-employment checks which include a police check are carried out before a new member of staff starts work at the home. The recruitment processes adopted by the manager should ensure people are protected from unsuitable staff. Care Homes for Older People Page 19 of 29 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. People who live at Park House generally have a comfortable and attractive home to live in. Evidence: A tour of the home was completed as part of this inspection. Communal areas, kitchen, laundry and disabled access bathrooms and toilets were viewed. And some individual peoples rooms were seen during the inspection. The home is registered to take 21 people. On the day of the inspection 19 people were living at the home. Eleven bedrooms are sited on the first floor and fifteen of the individual rooms have en-suite facilities. There are three shared rooms all of which have en-suit facilities. Two people who were sharing a room were spoken with. They said they had chosen to share a room. The room had been personalised with items of their choice. Peoples individual rooms are fitted with twist locks that can be easily opened form the inside. Toilets and bathroom are fitted with the same type of locks; these can be opened by staff in an emergency if needed. Locks to individual rooms, toilets and bathrooms were all capable of being opened from the outside with a coin or key. People were able to go freely between the two communal lounges in the home and to their individual rooms. The home has a spacious and attractive garden. From the garden there was open Care Homes for Older People Page 20 of 29 Evidence: access to the car park and a busy main road. The facility was therefore, not suitable for people with dementia. This was raised at our lat key inspection. The manager advised that they were unable to close the gate to the home because access was from a busy main road, which could cause problems. People were using the garden with staff members during the inspection. One persons room entered during the inspection had a strong unpleasant odour. The manager advised that the carpet was cleaned regularly and they were looking at ways to reduce the odour in the room. Another persons room had a chair cover that was soiled on the first day of the inspection. Staff ensured this was cleaned before the end of the inspection. The manager advised that she had set up a system to check individual rooms where soiling may take place using a check list for staff to complete. The cabled noted to be across the floor in one room causing a trip hazard at our last inspection had been moved and no longer posed a risk to the person using the room. Staff had access to gloves and aprons when providing care and hand wash facilities were provided. The manager has ensured that staff have access to policies and procedures relating to infection control. The staff records viewed showed that staff have had access to training for infection control. The homes kitchen was clean. Food in fridges and freezers was appropriately stored. The laundry had painted cleanable walls and a painted floor. The paint on the floor of the laundry was wearing off; this would make it difficult to clean. The manager advised that the floor in the laundry was one of the things on the list of maintenance for the home. Care Homes for Older People Page 21 of 29 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. There are adequate numbers of trained or experienced staff at most times. However by not have a dedicated cook and domestic this may mean care staff do not have as much time as they did to spend with individual people living at Park House. The recruitment practices in place at Park House should protect people from unsuitable staff. The people who live at Park House can have confidence that the staff team who care for them have access to training that will help them understand their care needs. Evidence: The manager advised that three staff had left at the same time five weeks earlier. The cook, domestic and one carer. This had meant that care staff were doing cooking and cleaning until suitable replacements could be found. The manager confirmed that staff had agreed to work more than 48 hours a week to cover the shift short fall for the interim period. Staff spoken with said they agreed to work the extra shifts so that people living in the home would have staff they were familiar with working with them. One commenting, we are a team and we pull together. The duty rota showed the number of staff on duty and in what capacity they were employed. This showed there were three staff on each morning and afternoon and two Care Homes for Older People Page 22 of 29 Evidence: waking night staff. The work had been organised to ensure care and domestic tasks were covered. The manager advised that she and the owner Mrs Bennett had been doing the cooking between them. And staff were undertaking cleaning tasks in the afternoons. Although this was not ideal, people asked said they were satisfied with their meals and the home was mostly being kept clean and tidy. One visitor had commented that their friends room was not being kept as clean as it had been. The manager advised that she was actively looking but had not found a cook or cleaner willing to fit in the homes work patterns. A new carer had started work since the carer left. The survey forms received from staff and the comments made during the inspection indicated that staff feel supported to do their work and have access to appropriate training. These included, Park House is a comfortable place with a real homely atmosphere, all staff are good at listening to the residents requests and do their utmost to get what they want. They are always going on training to up date their skills and knowledge. In general personal care is of a high standard and the home is pleasant and shared areas and rooms are generally well kept. The number of staff who had achieved an NVQ (National Vocational Qualification) level 2 in care or above was discussed with the manager. She advised that she had an NVQ 4 in management and 3 staff had achieved an NVQ level 2 and a further 3 had achieved and NVQ level 3. This showed that 50 of the staff employed had achieved and NVQ level 2 or above. The manager advised that new staff appointed would be encouraged to complete an NVQ level 2 in care. Two staff files were seen as part of this inspection. These contained the information, which supports the manager has a robust recruitment process. Pre employment checks included; reference checks, application forms and police checks. The staff files seen also contained a signed copy of the contract of employment. The manager provided the homes policies and procedures for inspection. These were easily available for staff working at the home. One new member of staff file looked at contained their induction programme, which the manager advised they were working with. The other staff files seen had copies of training agreements which had been signed by the registered owner and the staff member. This shows that a commitment has been made to ensuring staff receive the training they need to do their jobs well. Care Homes for Older People Page 23 of 29 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 management practices in the home should protect people who live at Park House and ensure the home is run in their best interest. Evidence: The Registered Provider and the Registered Manager, both hold relevant qualifications, which include the Registered Managers Award. They have many years experience in the care of older people. Management tasks are shared between the Registered Provider and Manager. Both also take an active role at Park House working with staff to provide care people who live there. The manager advised that people and or there relatives are asked about their satisfaction with the services provided at Park House. Completed surveys were available with some peoples care plan files. However the results of these had not been analyzed and made available for the people living at Park House or the Commission. The manager advised that in addition to these people living at the home and their relatives are asked about their views of the home. The manager and owner Care Homes for Older People Page 24 of 29 Evidence: have responded appropriately to any Requirements or Recommendations the Commission has made. The manager confirmed that Park House does not manage any money for people living at Park House. People or their Representative are billed separately for expenditure; reducing the need for people to have money held on their behalf. She also advised that people are encouraged to manage their own affairs for as long as they were able. Records of supervision for staff were being kept these showed that staff receive regular supervision with the manager. The manager advised that the training and development needs of staff are discussed at supervision meetings and training organised if this is agreed with the staff member. The two supervision records seen had information about future training plans for the staff member. Staff spoken with during the inspection said they were supported to do their work and had good access to training. Two of the people spoken with said staff were very understanding. Maintenance records were seen, these showed satisfactory routine maintenance of the homes equipment and systems and included lift servicing and electrical appliance testing. The risk assessments produced for the homes environment were available for the inspection. Accident records were being kept as required. A system for reporting incidents to the Commission was in place which means the Commission has been kept informed of any untoward instances that affect people living at Park House. The fire log book had been kept up to date and showed that regular fire safety checks are carried out and staff received fire safety training. The manager provided information regarding the company that checks fire extinguishers and fire safety systems in the home regularly. Copies of receipts for their service were seen. The manager confirmed that all new staff receive induction training that broadly follows the Skills for care guidelines. An example of the induction used for new staff was available for inspection. Care Homes for Older People Page 25 of 29 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 26 of 29 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 1 9 13 The Registered person shall 27/10/2009 make arrangements for the recording, handling, safekeeping, safe administration and disposal of medication received into the care home. Controlled drugs must be returned to the pharmacy in line with the medication code when they are no longer required by the person they have been prescribed for. Records of returned should be kept in the controlled drug book and the homes medication return book. This will provide a clear audit trail for medication stock control management. And ensure that the risk of people receiving medication they no longer require will be reduced. Care Homes for Older People Page 27 of 29 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 1 7 Risk assessments for people who want to go outside the home should be completed to ensure their safety. The reasons for people being restricted from going outside unaccompanied should be reflected in a risk assessment as well as their plan of care. A copy of the record of medications returned to pharmacy should be available at the home for inspection. A cook should be appointed to prepare meals for people who live at Park House as soon as possible The registered person should consider making the garden area secure to enable people to use it independently if they are able. The manager should ensure that all the peoples individual rooms are clean and free from odour. The registered manager should appoint a new cook and domestic as soon as possible. The results of an annual quality audit of the home should be provided for people who use the service and the Commission 2 3 4 9 15 19 5 6 26 27 7 33 Care Homes for Older People Page 28 of 29 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. 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. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!