Care Home: Park House Nursing Home

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What the care home does well The home works well at ensuring only people whose needs can be met are admitted to the home. Prospective residents are given lots of information about the home and are fully assessed prior to admission to ensure the home is able to meet their individual needs. People appear well looked after by a team of staff who know them well. Staff are friendly and helpful and communicate well with residents and visitors. People`s health needs are closely monitored and staff work well with health and social care professionals, ensuring their health and wellbeing is promoted. Residents are supported by a trained and committed staff team, which benefits their care. Staff are confident and competent in their roles and they demonstrated a clear understanding of the people whose care we looked at in detail. The majority of care staff hold a nationally recognised care qualification known as NVQ at level 2 and above. This ensures people living home are cared for by qualified workforce. People`s views are listened to because the home has systems in place which ensure any concern, or complaint is welcomed and acted upon in order to improve the service it provides for its residents. Park House is managed in the best interests of the people who live there. People spoken with considered the service is well managed and that the manager and proprietor are open and approachable. One of the residents involved in the inspection said `The staff are good`. A relative told us that they are `very pleased` with the care provided. Staff told us: `The general care here is excellent, staff morale is high and I`m very happy working here` `We all care for the residents and each other` `We treat people here as we would like to be treated. We work well as a team, it`s a friendly atmosphere and a happy place` What has improved since the last inspection? Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 The last key inspection of this service was undertaken on the 12th September 2008. The manager has done the things that we asked, which has improved outcomes for people using the service. The new passenger lift is now operational and this provides safer accessibility for people accommodated on the first and second floors of the home. Training opportunities for staff have improved. This ensures they are equipped with the skills and knowledge to meet the individual needs of the people they support. For example lots of staff have received training to help them understand and effectively support people with dementia related illnesses. Care plans have been redeveloped and are more detailed. This ensures people receive the care they need and in a way that they prefer. Improvements have been made to the environment to provide people with more homely place to live. How the home supports people with the management of their medication has been reviewed to ensure the safe receipt, storage, handling and administration of medication takes place. This helps safeguard people who require support with the management of medication. Assessments have been developed for each individual to reflect their capacity and any restrictions on freedom have been assessed to ensure people are not deprived of their liberty. A detailed induction programme for nursing staff has been developed and implemented as recommended by the previous inspection. This confirms they are competent and confident to carry out their nursing duties as expected of them, benefiting resident care. What the care home could do better: More could be done to assist people with a dementia related illness for example key documents such as the complaints procedure, menu`s and activity programme could be developed in an easy read format. Objects of reference or pictures around the home may also help people familiarise themselves with the environment. When recruiting new staff the home must ensure they obtain two written references to include a reference from the applicant`s last employer and a full history of employment. This is to ensure that people living at the home are cared for by staff that have been suitably checked. Feedback gained during our visit indicate that people are satisfied with the service and the only suggestions for improvement was for a further stand aidPark House Nursing HomeDS0000041214.V376911.R01.S.doc Version 5.2 hoist to be obtained for people accommodated on the first-floor, and a greater choice of meals provided. Key inspection report CARE HOMES FOR OLDER PEOPLE Park House Nursing Home Kinlet Bewdley Worcestershire DY12 3BB Lead Inspector Rebecca Harrison Key Unannounced Inspection 10th August 2009 11:00 DS0000041214.V376911.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park House Nursing Home Address Kinlet Bewdley Worcestershire DY12 3BB 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) 01299 841262 carla.gregory@virgin.net Park House Care Ltd Mrs Melanie Allen Care Home 40 Category(ies) of Dementia (18), Old age, not falling within any registration, with number other category (40) of places Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home with Nursing (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 40 Dementia (DE) 18 The maximum number of service users to be accommodated is 40. 2. Date of last inspection 12th September 2008 Brief Description of the Service: Park House is registered to provide both personal and nursing care for up to a maximum of 40 Older People, to include 18 people with a dementia related illness. Accommodation is provided in an older property which has been enlarged by two extensions. The accommodation is arranged over three floors providing 10 single ensuite bedrooms, 20 single and 5 shared rooms to accommodate 40 residents. A range of communal areas are provided which are homely and comfortable. Access is gained to the first and second floors via a new passenger lift and the home sits amidst gardens and grounds, which provides a safe outside environment for residents to enjoy. As the home is in a rural location, transport links are limited. The Registered Manager of the home is Mrs Melanie Allen, who is supported by a team of well-qualified and experienced staff covering all aspects of the service the home provides. Park House Care Ltd makes its services known to prospective residents in their Statement of Purpose, and Brochure/Service User Guide. The fees charged range from £550.00 to £750.00 per person per week based on the needs identified on assessment. Additional charges made are for hairdressing, toiletries, and newspapers. Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good outcomes from the service they receive. The visit to the service was undertaken by two inspectors over four hours. We arrived at the home at 11am. The people who live and work at the home did not know that we were coming. A range of evidence was used to make judgements about this service. Six residents were involved in the inspection process; we met with five staff and a visiting relative. We looked at some parts of the home and sampled a number of records to staff training, recruitment, quality assurance and health and safety records. Five people completed surveys informing us of their views of the home and the feedback gained has been included in our report. The care received by three people with a range of needs was looked at in detail. This included looking at personal records such as care plans, health records, daily records and discussing their care with them, where possible, and the staff who support them. This helps us gain information and understand the experiences of people who use the service and the quality of care they receive. Given the needs of the people living at Park House, a large number of people were unable to share their own experiences of living at the home. However we had the opportunity to observe people being supported by the staff on duty and staff were able to tell us how they care for people ensuring their needs are met. We looked at the outcomes for people living at Park House and information to produce this report was gathered from the findings on the day of our visit and also the information that we have received, or asked for, since our last key inspection. The manager completed an Annual Quality Assurance Assessment (AQAA) document for us, as requested. The AQAA is a self-assessment and a dataset that is filled in once a year by all providers. This was detailed and informed us about how they are meeting outcomes for people using their service and is an opportunity for them to share with us areas that they believe they are doing well. Neither the manager or proprietor was present during our visit however staff on duty assisted with the inspection process and we had the opportunity to speak with the proprietor via telephone during and after our visit. Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 6 What the service does well: The home works well at ensuring only people whose needs can be met are admitted to the home. Prospective residents are given lots of information about the home and are fully assessed prior to admission to ensure the home is able to meet their individual needs. People appear well looked after by a team of staff who know them well. Staff are friendly and helpful and communicate well with residents and visitors. Peoples health needs are closely monitored and staff work well with health and social care professionals, ensuring their health and wellbeing is promoted. Residents are supported by a trained and committed staff team, which benefits their care. Staff are confident and competent in their roles and they demonstrated a clear understanding of the people whose care we looked at in detail. The majority of care staff hold a nationally recognised care qualification known as NVQ at level 2 and above. This ensures people living home are cared for by qualified workforce. Peoples views are listened to because the home has systems in place which ensure any concern, or complaint is welcomed and acted upon in order to improve the service it provides for its residents. Park House is managed in the best interests of the people who live there. People spoken with considered the service is well managed and that the manager and proprietor are open and approachable. One of the residents involved in the inspection said The staff are good. A relative told us that they are very pleased with the care provided. Staff told us: The general care here is excellent, staff morale is high and Im very happy working here We all care for the residents and each other We treat people here as we would like to be treated. We work well as a team, its a friendly atmosphere and a happy place What has improved since the last inspection? Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 7 The last key inspection of this service was undertaken on the 12th September 2008. The manager has done the things that we asked, which has improved outcomes for people using the service. The new passenger lift is now operational and this provides safer accessibility for people accommodated on the first and second floors of the home. Training opportunities for staff have improved. This ensures they are equipped with the skills and knowledge to meet the individual needs of the people they support. For example lots of staff have received training to help them understand and effectively support people with dementia related illnesses. Care plans have been redeveloped and are more detailed. This ensures people receive the care they need and in a way that they prefer. Improvements have been made to the environment to provide people with more homely place to live. How the home supports people with the management of their medication has been reviewed to ensure the safe receipt, storage, handling and administration of medication takes place. This helps safeguard people who require support with the management of medication. Assessments have been developed for each individual to reflect their capacity and any restrictions on freedom have been assessed to ensure people are not deprived of their liberty. A detailed induction programme for nursing staff has been developed and implemented as recommended by the previous inspection. This confirms they are competent and confident to carry out their nursing duties as expected of them, benefiting resident care. What they could do better: More could be done to assist people with a dementia related illness for example key documents such as the complaints procedure, menus and activity programme could be developed in an easy read format. Objects of reference or pictures around the home may also help people familiarise themselves with the environment. When recruiting new staff the home must ensure they obtain two written references to include a reference from the applicants last employer and a full history of employment. This is to ensure that people living at the home are cared for by staff that have been suitably checked. Feedback gained during our visit indicate that people are satisfied with the service and the only suggestions for improvement was for a further stand aid Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 8 hoist to be obtained for people accommodated on the first-floor, and a greater choice of meals provided. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Park House Nursing Home DS0000041214.V376911.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 Park House Nursing Home DS0000041214.V376911.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standard 6 does not apply to this service) 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. Information about Park House is made readily available to help prospective residents and their representatives make an informed choice about whether the home is suitable to meet their individual needs. A complete assessment of their needs is undertaken with prospective residents and others close to them prior to admission to ensure Park House is the appropriate service for them. EVIDENCE: Prospective residents and their representatives are provided with information about the service provided at Park House in the form of an information pack which includes the Statement of Purpose, Service User Guide, activity programme, the menu and a questionnaire for people to complete and provide Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 11 the matron with feedback on their experience when viewing the home. This information enables people to make an informed choice as to whether Park House is suitable to meet their individual needs. Following our visit these documents were updated to reflect that the home does not provide a designated area for people with dementia related conditions, as recommended at the last inspection. This ensures people looking for a service are aware that communal areas are shared and that some areas of the home have restricted access to ensure peoples safety. Prospective residents and their representatives are encouraged to visit the home and are provided with information about the service. We spoke with a representative of a person recently admitted to the home and they confirmed that a needs assessment was undertaken by the manager prior to admission to ensure the home was able to meet the persons needs. The assessment includes gathering information about health and personal care needs, medical history and activities of daily living. Residents/representatives are requested to complete a personal fact file which helps the staff gain a good overview of the individual prior to admission. The care files sampled evidence detailed assessments are undertaken. Park House Nursing Home DS0000041214.V376911.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans have improved so have the necessary information they need ensuring peoples health and personal care needs are met in a way that they prefer. Improved medication systems ensure that staff effectively support people with the management of their medication promoting their well-being. The actions of staff and their approach to care ensures that residents are treated with respect and their right to privacy is upheld. EVIDENCE: We looked at the care records held on behalf of three people who live at Park House. Following our last visit new acute care plans have been developed and implemented to make it easier for staff to follow and these are used in conjunction with long term care plans. The care plans sampled were detailed Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 13 and covered areas to include peoples personal and health care needs, medication, activities for daily living, risk management and health monitoring tools such as weight and wound care. Care charts have also been introduced for individuals who require a higher level of intervention for example monitoring of nutritional intake and pressure area care. The documentation available ensures that staff are familiar with the assessed needs of the individuals they care for and ensure individuals receive the appropriate care and assistance they need. Records sampled evidence that peoples needs are regularly reviewed and any identified risks such as manual handling are assessed to ensure peoples safety. We spoke with staff on duty about the needs of the three people that we looked at in detail and they demonstrated a good knowledge of peoples individual needs, which was consistent with the information held on their care files. Not everyone was able to share their experiences of what it is like to live at the home, however observations made during our visit evidence that staff are alert to changes in mood, behaviour and the general wellbeing of the individuals in their care. All three care plans sampled contained a deprivation of liberty assessment and identified any restrictions in place. One of these has led to the home applying for a deprivation of liberty authorisation. An assessment of capacity has recently been undertaken by a professional and following our visit we were advised that authorisation has been granted. This ensures that any restrictions in place are in the persons best interests. We looked at how the home supports people with the management of their medication. Since our last visit procedures have been reviewed and trained staff have been provided with guidelines explaining the process of drug management to ensure they fully understand the process of receiving administering and disposing of medicines in order to promote good health. Examination of medical records for the three people we looked at in detail was satisfactory and confirmed that people were getting the medicines as prescribed. Minutes of a recent staff meeting held evidence that the management of medication was discussed and that staff are encouraged to seek the advice of the manager if they have any concerns. Observations evidence that staff are sensitive to the needs of the individuals in their care. Staff were seen promoting privacy and dignity and interacted with residents in a professional manner. Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Park House and provided with opportunities to experience a lifestyle based on their preferences and abilities that ensures their self-esteem and well-being. People are provided with healthy, well presented meals in accordance with their dietary requirements and choice. EVIDENCE: The residents at Park House are provided with a range of activities that they can choose to participate in. Activities on offer include music and movement, hand massage sessions provided by visiting therapist, librarian visits, Holy Communion and arts and crafts. The newsletters displayed in the reception area detail events and information about the local community to include copies of the residents’ newsletter, local news, bulletins and support groups. People told us that a recent garden party was held which proved successful. The AQAA states We have tried to involve as many residents as possible in the external outings. Currently 15 of the 36 residents have been involved in an external trip. It also reports that aromatherapy sessions have been increased to benefit those residents who are unable to participate in other activities. Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 15 Prior to admission information is gained from residents and their representatives about peoples pastimes, hobbies and interests, special relationships, achievements and personal preferences to include food, drink, favourite clothes and preferred music. This process provides staff with information in terms of planning activities and providing person centred care. The home operates an open visiting policy and relatives were seen visiting the home during the inspection. Visitors were made welcome and arrangements to see their relatives in private were made available. A visiting relative told us they are very happy with the care provided. Throughout the inspection people were offered a choice of refreshments and those spoken with confirmed they are happy with the meals provided. The mealtime was observed and the meal looked appetising and nutritious. People requiring assistance were offered support in a sensitive manner and staff spoken with demonstrated a good understanding of the dietary needs of the people whose care we looked at in detail. One person said that the meals could improve and a greater choice of food provided. The ground floor dining area is to be redecorated in the next 12 months to provide residents with a more pleasing environment in which to dine. Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their representatives have access to a complaints procedure, which is accessible and ensures the views of people are listened to. Staff receive training so they have an understanding of adult protection to ensure people they care for are protected from abuse, ensuring their wellbeing. EVIDENCE: Residents and their representatives have access to a complaints procedure, which is displayed in the home and included in the welcome pack. The home maintains a record of all complaints, no matter how minor. Although the record was not accessible at the time of our visit to the home, we were provided with the information required shortly after our visit and this clearly shows us complaints are dealt with in a timely matter and resolved in peoples best interests. The proprietor committed to ensuring the complaints log is readily accessible so that staff are able to log any concerns or complaints in the absence of managers. People we spoke with demonstrated an understanding of what to do if they were not happy with the service provided. Staff at Park House have access to the multi-agency policies and procedures in relation to adult protection and receive training. Staff spoken with reported Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 17 that they would immediately report any allegation to the management team and they demonstrated an understanding of their duty to safeguard people, although they were not clear of the referral process in the absence of managers. The proprietor committed to address this at the next staff meeting. No referrals have been under safeguarding adult procedures since our last visit to the home. Since our last visit to the home a number of staff have received training in managing behaviours that can challenge due to peoples dementia related conditions. The training equips staff with the skills to keep them safe and ensure they adopt a consistent approach when supporting residents whose behaviours may challenge the service. Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements to the environment continue to be made to provide people living at Park House with a clean, comfortable and well maintained place to live where they feel safe and secure. EVIDENCE: A number of environmental improvements have been made to the home to enhance the living accommodation for people living at Park House. Improvements include the redecoration of the ground floor corridor, the conversion of the old lift shaft into a much-needed storage area and redecoration of a number of bedrooms. A bedroom was being redecorated at the time of our visit. A variety of specialist beds have been purchased in addition to pressure relieving equipment to meet the needs of the residents. The passenger lift is now operational providing safer access for people and the Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 19 home now provides ten bedrooms with en-suite facilities, which has enhanced the living accommodation and helped reduce the demand for communal bathrooms. The AQAA identifies that additional improvements are necessary and the proprietors are working towards this. For example the need to redecorate communal areas on the ground floor and refurbish the bathroom on the first floor to provide people with more comfortable facilities. The AQQA reports that the secure a patio area is proving popular and enables residents and their visitors to enjoy the fresh air and sunshine in safety. Residents are able to access the grounds accompanied by staff. The front door continues to be locked to ensure the safety of people with dementia related conditions. However the home has identified this as a restriction and have carried out the necessary assessments to ensure that this is not a deprivation of anyones liberty. We looked at the shared areas of the home, the bedrooms of the people whose care we looked at in detail. The home was welcoming, and the bedrooms seen were personalised and equipped to meet their individual needs. People appeared comfortable and relaxed in their surroundings and one of the residents we spoke with told us that they enjoy living in the home. The areas of the home we toured were found clean and free from odours. Domestic staff are employed to provide people with a clean environment to live. Substances such as cleaning products that could cause harm to people are safely stored and staff training records identify all but seven staff have completed training in the control of infection and contamination. Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 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. Staff work positively, are employed in sufficient numbers and receive good training opportunities to equip them with the skills and knowledge to meet the individual needs of the people they care for. The majority of checks are undertaken on new staff employed however improvements to the homes recruitment practices would provide greater protection for residents living at home. EVIDENCE: People living at Park House are cared for by an established staff team who appear committed to their work. Staff on duty demonstrated a good understanding of the individual needs of the people whose care we looked at in detail. Discussions held with residents and a visiting relative evidence people are satisfied with the care provided. Staff have developed positive working relationships with the people in their care and they told us that they work well as a team and that Park House is a happy place to work. The people we spoke with considered that staffing levels are appropriate and effective to meet the individual needs of the people living at the home. The Rota was an accurate reflection of the staff on duty at the time of our visit and Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 21 evidenced that staff sickness and the use of agency staff is minimal, providing continuity of care for the residents. The skill mix of staff is also considered when developing rotas to ensure staff on duty are appropriately qualified and trained. We were advised the home is looking to recruit an additional registered nurse and a care assistant to cover holidays, training and sickness. Discussions held with a number of staff on duty evidence that opportunities for training has improved equipping them with the skills and knowledge to meet the individual needs of people living in the home. Since our last visit a number of staff have received training such as dementia awareness, depression in the elderly, side effects of major tranquillisers and managing behaviours. Two staff have completed sensory deprivation awareness training course. The staff training matrix has recently been reviewed and updated and reflects the training that staff have undertaken in addition to their identified training needs. 21 of the 25 care staff employed hold a nationally recognised care qualification known as NVQ at 2 and above, providing a qualified workforce benefiting residents care. We looked at the recruitment records for four staff employed since we last visited the home. The majority of records required were available such as a health declaration, proof of identity and criminal records bureau checks. All four files contained written references however two files failed to contain a written reference from the previous employer. Reasons provided for one member of staff were valid however the proprietor was advised to ensure such reasons are clearly documented. The proprietor committed to ensure that all of the required documentation is secured prior to new staff commencing work with vulnerable adults. Records available evidence that new staff receive induction to monitor their progress and an induction programme for nursing staff has been developed and implemented as recommended by the previous inspection. This confirms they are competent and confident to carry out their nursing duties as expected of them. Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management styles ensure continuous improvement and enhance the lives of people living at Park House. The home is managed and maintained in a manner which ensures the safety of residents and the staff team. EVIDENCE: The registered persons were not on-site during our visit however the proprietor was available via telephone to assist with the inspection process during and after our inspection. The registered manager/matron has the required qualifications required of her position and has worked at Park House for over Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 23 13 years. The Statement of Purpose states the manager is an experienced and respected manager, who has been instrumental in setting and achieving high standards which was reflected in discussions with the staff on duty who reported the management team as being approachable and have very good leadership skills. The proprietor is based on-site throughout the week to assist with the overall management of the service and discussions held during our visit indicate people consider the service to be well-managed. The manager, proprietor and registered nurse have recently undertaken training in the Deprivation of Liberty Safeguards and assessments of each individual have taken place. As previously reported an application for authorisation has been made to the local authority and granted. The home has facilities for safe storage of valuables and a record of all items held on behalf of residents is maintained and two signatures obtained to ensure residents are safeguarded. A small amount of money is held on behalf of three people although we were unable to access records held on this occasion. Discussions held with the proprietor and information recorded in the AQAA indicate systems are in place to safeguard the residents concerned however we advised the proprietor to ensure information about the management of peoples finances is clearly documented on their care plans. The Annual Quality Assurance Assessment (AQAA) forwarded to CQC reflects both the strengths and areas for improvement. The home welcomes suggestions for improvements and satisfaction questionnaires are available next to the visitors book, held in the reception area of the home. Questionnaires have recently been distributed and 17 completed questionnaires have been received to date. Comments evidence peoples satisfaction with the service provided and include: I would like to state that I find all aspects of Park House to be excellent and staff are extremely kind and considerate at all times I am more than happy with their tender loving care that my mother gets; I bless the day I found Park House! We always feel very welcome when we come to see X. Staff are very friendly and always informative of his condition. We are very happy with his care at Park House Very satisfied with the excellent standards of care, the friendly staff and the overall quality of nursing and social care given to all the residents I feel very strongly that that the staff at Park House are absolutely fabulous Still as happy as ever with the care my dad receives. The staff are all extremely caring and capable and always ready with a smile on welcome. I Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 24 know you are incredibly busy but you still manage to be friendly with all of us, residents and visitors thank you We looked at a variety of health and safety records and the checks that staff do to prevent people from being placed at risk of harm. Checks are undertaken at the required frequency to include water temperatures, fire, emergency lighting, bedrails, electrical checks, servicing of equipment this ensures the safety of residents and staff. Staff on duty confirmed that they receive training in safe working practices which helps to keep people safe for example moving and handling, infection control, food hygiene and fire. Training in first aid is currently being sourced and training in moving and handling is scheduled very shortly for new staff and those staff who require refresher training. We were advised that the home is fully compliant with the fire and environmental health departments and staff spoken with confirmed that they are happy with a health and safety arrangements and that any maintenance issues are quickly addressed by the maintenance person. Accident records were not accessible during our visit however the proprietor assured us that procedures for monitoring of accidents has been revised in the best interests of people living at home. Park House Nursing Home DS0000041214.V376911.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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 OP29 Good Practice Recommendations Recruitment practices should be reviewed to ensure all the checks as required are undertaken to include obtaining two written references (one from the last employer) in addition to a full employment history. This is to ensure that people living at the home are cared for by staff that have been suitably checked. Park House Nursing Home DS0000041214.V376911.R01.S.doc Version 5.2 Page 27 Care Quality Commission Care Quality Commission West Midlands Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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