Care Home: Park House Care Home

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What the care home does well Park House is a friendly home where staff work hard to make sure that residents living there are comfortable and well cared for. Since the home has changed hands there have been major improvements made in several areas. Prospective residents are provided with good information to read prior to moving in, and are visited by the manager or her deputy to assess their individual needs. A care plan of their individual care, social and personal needs is written by the manager and monitored regularly by their key worker to ensure that the service can continue to meet their needs. Visitors consulted said that they always feel welcomed into the home by the staff and it was clear that the homes welcoming atmosphere encourages people to visit. People living at the home are offered choices throughout the day especially with their choice of meals which has improved since the last inspection. Any complaints are listened to and acted upon appropriately. There is enough staff on duty to meet the needs of the residents currently living at the home. What has improved since the last inspection? The team and manager at Park House have worked hard to improve and develop its service. The requirements from the last inspection have been implemented, these are that the activities have become more meaningful and residents have the opportunity to fulfill their social interests. A new bathroom has been added on the ground floor so residents now need not go to the first floor for a bath. Out of the twenty three bedrooms, eighteen have been fully refurbished with new furniture, beds, carpets, bedding, curtains, lighting and redecoration. The manager has allocated time from the staff rota to allow her to complete her managerial responsibilities and the rota is completed prior to any shift changes. The company Black Swan undertakes regular monitoring of the service and staff cooperates with formal supervision with the manager. Some of the new beds were considered quite low for residents to get out of independently and these have been changed. There has been two single en suite bedrooms added to reduce the need to use shared bedrooms and the front lounge has been moved to the rear of the building with the addition of two full sized disabled toilets. Evidence showed that the manager seeks advice from specialist professionals when this is needed. The coloured plastic beakers have been changed to more appropriate glasses. The tea time meal was considered too early and left a long gap until breakfast and this is now served a little later in the afternoon. The staff rota has been altered to allow a little more flexibility for staff to work and the majority of staff have attended some dementia awareness training to enable them to look after people with short term memory loss. What the care home could do better: There are still several areas within the home that require updating and refurbishment. The dining room lighting is quite dark and should be improved. Several of the bedrooms require redecorating and the furniture requires updating. The lift is of an old style and reduces the aim for residents to remain independent as they require assistance from their visitors or members of staff to be able to use it. The garden has been cleared of the old trees and shrubs but the gravel that has been laid reduces the residents independence again as this is hard for frail and wheelchair users to navigate. To reduce the fire risk within the home the manager must ensure that all visitors entering and leaving the building must sign the visitors book so staff know how many people are in the building at all times. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Park House Care Home 6 Alexandra Road Great Yarmouth Norfolk NR30 2HW 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 assessment of the service. We call this full assessment a ‘key’ inspection. Lead inspector: Hilda Stephenson Date: 1 9 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. They reflect the things that people have said are important to them: 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 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 23 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 Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Park House Care Home 6 Alexandra Road Great Yarmouth Norfolk NR30 2HW 01493857365 01493851045 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Black Swan International Limited Carol Ridler Care Home 25 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration Category(ies): old age, not falling within any other category Additional conditions: Number of places (if applicable): Under 65 0 Over 65 25 Date of last inspection: Brief description of the care home: 2 3 0 7 2 0 0 7 Park House is a large detached house situated in the centre of Great Yarmouth, close to local amenities. The service has recently been purchased by Black Swan International, an established care provider with other homes in Norfolk and Essex. It continues to be managed by Carol Ridler. Accommodation is provided for up to 25 older people, comprising of 21 single and 2 shared bedrooms, all have en-suite facilities. There is one large lounge and one large dining room with a small quiet lounge both at the rear of the house. The home has a small-enclosed garden with a large car parking area. The current fee levels for the service are £284 to £470 per week. Care Homes for Older People Page 4 of 23 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 How we did our inspection: This unannounced visit to the home took place during the day on 19th March 2009. One of the proprietors, the manager and deputy manager were in attendance during most of the day. During the inspection a tour of the building was undertaken, staff practice was observed, records and files were read and checked, and some residents and visitors were consulted to provide the evidence when compiling this report. Care Homes for Older People Page 5 of 23 What the care home does well: What has improved since the last inspection? The team and manager at Park House have worked hard to improve and develop its service. The requirements from the last inspection have been implemented, these are that the activities have become more meaningful and residents have the opportunity to fulfill their social interests. A new bathroom has been added on the ground floor so residents now need not go to the first floor for a bath. Out of the twenty three bedrooms, eighteen have been fully refurbished with new furniture, beds, carpets, bedding, curtains, lighting and redecoration. The manager has allocated time from the staff rota to allow her to complete her managerial responsibilities and the rota is completed prior to any shift changes. The company Black Swan undertakes regular monitoring of the service and staff cooperates with formal supervision with the manager. Some of the new beds were considered quite low for residents to get out of independently and these have been changed. There has been two single en suite bedrooms added to reduce the need to use shared bedrooms and the front lounge has been moved to the rear of the building with the addition of two full sized disabled toilets. Evidence showed that the manager seeks advice from specialist professionals when this is needed. The coloured plastic beakers have been changed to more appropriate glasses. The tea time meal was considered too early and left a long gap until breakfast and this is now served a little later in the afternoon. The staff rota has been altered to allow a little more flexibility for staff to work and the majority of staff have attended some dementia awareness training to enable them to look after people with short term memory loss. Care Homes for Older People Page 6 of 23 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by telephoning our order line – 0870 240 7535. Care Homes for Older People Page 7 of 23 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 23 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 the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People moving into the home can be confident that their individual needs are assessed, they are given written details about the service and that the staff can care for them. Evidence: The written records are made available for all prospective residents and their relatives explaining details about the service. Each new resident is invited to visit the home prior to admission when the manager goes to assess their individual needs. The records of the latest resident who had recently moved into the home was read, these contained detailed information about their care needs and a detailed contract explaining the services provided by the home. The manager confirmed that she visits all prospective residents to discuss how the home and the staff can care for them. The home does not offer intermediate care, but does offer short term respite care when the same admission procedure is followed. Care Homes for Older People Page 9 of 23 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 the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their health and personal care needs can be met by this service. Evidence: Two care plans were looked at in significant detail. The care plans used are provided by the main company of Black Swan, both care plans were detailed and contained good clear information to enable staff to attend to the residents needs. Evidence of risk assessments and how often these were reviewed were in place. Each care plan seen had been signed by the resident. Each resident had a key worker who looked after smaller tasks such as shopping, arranging their laundry keeping their rooms tidy and generally caring that little extra for them. Evidence of good health care support was seen with regular health professionals visiting the home to offer support and advice. The home had implemented MUST screening and is actively improving the nutritional needs of those residents deemed at risk. A recommendation from the previous inspection to improve the low beds had been implemented to enable residents to be able to get out of bed easier. Staff were seen looking after residents in a way that promoted dignity and respect. The medication had recently been audited by the PCT, with the report being read during this visit. The standard had been recorded as good. The two resident’s medication records were checked against the medication in stock and were found to be satisfactory. Evidence of the ordering, administering, storage and Care Homes for Older People Page 10 of 23 returning of medicines was also checked. Medication is administered by care staff who have received appropriate training, and evidence of this was obtained by checking staff files and when speaking with them. Care Homes for Older People Page 11 of 23 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 the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Park House are able to make choices in their daily lives. A range of activities are available however, a more detailed life history would go towards making the activities more personalised. Visitors are warmly welcomed into the home. Evidence: People that are able are encouraged to remain involved with their daily life activities such as tidying their room and small household chores, although this does not suit everyone. It was observed that some residents were happy to be involved with laying tables for lunch and keeping the lounge tidy. Improvements to the residents past lifestyle, interests, hobbies and family background could be introduced to enable staff to gain a better understanding and aim the activities to become more personalised. There is a weekly actives programme displayed in the dining room so residents can make there own mind to attend, these are mainly arranged during the quieter afternoon period. Evidence that outings are offered to residents was seen after visiting the Tide and Time Museum, Yesterdays World and the Sea Life Centre. Several of the residents who attended these confirmed that they had enjoyed going out. The minutes of the residents meetings confirmed that these outings had been discussed and arranged with residents attending these meetings. During this visit the home was very busy, as the hairdresser was attending to several residents, many visitors were seen coming and going throughout the day, with several being offered a cup of tea. The visitors who were spoken to confirmed that they were always welcomed into the home and felt included when outings and events were arranged. Staff appeared to respect the wishes of residents who did not wish to be included with the organised activities. Past recommendations from the previous report had been implemented with the Care Homes for Older People Page 12 of 23 coloured plastic beakers having been replaced with more appropriate glasses, and the tea time meal was served a little later in the evening. Improvements to the kitchen had been made since the last inspection with adequate storage of food and evidence of the use of fresh seasonal fruit and vegetables was now in place. A recent environmental health visit had issued one requirement which had been easily remedied. The chef, cooks the breakfast and lunch and prepares the food for tea time, although the care staff serves this meal. All the comments received from the residents showed that they enjoy the meals offered and have a choice from the menu. The lunch time meal was observed, this was a sociable occasion with residents taking there time, and those who required assistance were helped in a discreet manner. The dining room was considered quite dark even though the lights were switched on, the manager should consider changing this so residents can see what they are actually eating. Care Homes for Older People Page 13 of 23 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 the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have access to a good complaints procedure and are protected by a trained staff team. Evidence: All residents are given a copy of the complaints procedure explaining that if they have any concerns that these would be dealt with in an unbiased manner. The residents who were spoken to confirmed that they felt comfortable talking to the manager if they had any concerns. One resident raised a concern how much the television was left on in the new lounge and this was passed onto the manager to deal with. Evidence was obtained by speaking with staff and reading there staff files that they had received updated information regarding adult protection through the NVQ training and induction programmes. The company policies were read and signed by staff when they had understood them. Care Homes for Older People Page 14 of 23 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 the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable environment; however there are shortfalls in some areas and these require updating. Evidence: Since the change of proprietor the home has had major redecoration and alterations to the environment. A new bathroom has been added on the ground floor so residents do not need to go upstairs for a bath. The hallway has been redecorated and had the old furniture removed. The lounge has been re situated at the rear of the home and two new en suite bedrooms have been completed, reducing the number of shared rooms. Several of the bedrooms have been refurbished however there are five bedrooms that still require refurbishment. The kitchen has been refurbished in line with modern day standards. Two new toilets have been situated beside the new lounge making for easier access for residents. Part of the garden is covered in gravel to improve the appearance of the front of the home. The remainder of the garden is accessible by double doors and a ramp at the side of the building. The gravel area is considered a risk for frail elderly people to walk on reducing the use of the area for mobile and wheelchairs users. A requirement issued at the previous inspection regarding the low beds has been dealt with and some of the beds have been replaced. The proprietor explained some areas of the building still require attention to improve the situation for residents; this is mostly redecoration and changing some of the older style furniture in five bedrooms. During this visit their were several visitors coming and going, and on three occasions the visitors book was not signed, to reduce the fire risk to these visitors the manager must ensure that all visitors sign the visitors book on entering and leaving the building to ensure the staff know how many people are in the building. The fire records and staff training were deemed up to date. Care Homes for Older People Page 15 of 23 Care Homes for Older People Page 16 of 23 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 the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be assured that there are enough staff working in the home to meet their needs, however the manager continues to work as part of the care team on some days of the week. The home has a clear recruitment procedure and continues to offer general training to its staff. Evidence: The home is registered to accommodate 25 people and there were nineteen people in residence on the day of inspection. Three care staff were on duty excluding the manager who was supernumerary, although works part of the week hands on and works part of the week undertaking her managerial responsibilities. Inspection of the staff rota, observation of the home and discussion with residents and visitors demonstrated that there are enough staff on duty to meet the peoples needs. Inspection of the staff files showed that the manager follows the companies recruitment procedure by obtaining two references and the required crb check before staff commence employment. All new staff are required to undertake an induction programme and are supervised before working with residents on there own. The staff files also showed that staff received appropriate training to help them assist residents, with more than half of the staff team either completed or working towards the accredited NVQ award. Several of the staff have had some form of dementia awareness training and first aid appears to be the only field to be updated this year. Care Homes for Older People Page 17 of 23 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 the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is generally good, however there are areas of the building and fire procedures that still require attention. Evidence: The registered manager continues to work part of the week undertaking her managerial responsibilities and works the other half of the week as part of the care staff team. She has worked at the home for over twenty years and has the appropriate qualifications and experience to fulfill her role. She clearly enjoys her role and is committed to the welfare of the residents under her care. The home has improved the quality assurance monitoring and a survey and regular monitoring is now being carried out by the company; this was read during this visit. Feedback is discussed at the residents meetings, when future plans for the outings and activities are also discussed. Some money is looked after for some residents and a sample was checked and found to be in good order. The manager now supervises staff on a more formal basis and records these sessions, this goes towards helping plan for their training needs in the future. Care Homes for Older People Page 18 of 23 Staff files were checked alongside maintenance records to ensure the environment meets the health and safety requirements. These were found to be satisfactory, however the visitors book is not always signed by people visiting the home and this is a fire hazard, as the staff must be aware of how many people are in the building at all times. The home is open to visitors during the day and is made secure overnight. There are still some areas of the home that require improvement, this is mostly redecoration and changing some of the older style furniture in bedrooms, although the company has altered quite a few areas since they took over the running of the home and this continues to be ongoing. Care Homes for Older People Page 19 of 23 Are there any outstanding requirements from the last inspection? Yes No x 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 20 of 23 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 19 23 The dining room lighting is quite dark and must be improved to allow residents to see what they eating. 20/05/2009 2 19 23 3 38 21 The proprietor must 20/07/2009 continue to improve residents bedrooms and update the furniture currently in place. To reduce the fire risk all 20/04/2009 visitors must sign the visitors book when entering and leaving the building so the manager knows how many people are inside at all times. 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 12 2 19 A more detailed life history of each resident should be compiled in the care plan, so that they can continue with their interests and hobbies both inside and outside the home. The lift is old and heavy for residents to use, the proprietor should look at a way to ensure residents can remain independent when wishing to use this. The garden area is covered in gravel and this is considered a risk for frail elderly people to walk on, reducing the use of Page 21 of 23 3 19 Care Homes for Older People the area for mobile and wheelchair users. Care Homes for Older People Page 22 of 23 Helpline: 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 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. ©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. Care Homes for Older People Page 23 of 23 - 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. 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