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Care Home: Park House Rest Home

  • 220 Havant Road Hayling Island Hampshire PO11 0LN
  • Tel: 02392465274
  • Fax: 02392765274
  • Planned feature Advertise here!

Park House is a detached residential care home situated within its own grounds, in a residential area of Hayling Island. The home is registered with the Care Quality Commission (CQC) to accommodate up to a maximum of 16 service users. The home benefits from a large rear garden and the front of the property is gravelled, with hanging baskets and flowers in the borders and provides parking for approximately 8 vehicles. The home is on a local bus route and the seafront at Hayling Island is within easy reach. The home meets the individual accommodation space requirements set out in the National Minimum Standards (NMS) 3rd edition for existing providers. For enquiries about fees contact the manager of the home.

  • Latitude: 50.824001312256
    Longitude: -0.98199999332428
  • Manager: Mr Edward John O'Brien
  • Price p/w: ~
  • UK
  • Total Capacity: 16
  • Type: Care home only
  • Provider: Mr Lee John Gosling,Ms Sally-Jayne Hoke
  • Ownership: Private
  • Care Home ID: 11973
Residents Needs:
Dementia, Old age, not falling within any other category, mental health, excluding learning disability or dementia

Latest Inspection

This is the latest available inspection report for this service, carried out on 15th December 2009. CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

For extracts, read the latest CQC inspection for Park House Rest Home.

What the care home does well The home welcomes potential service users and their families to visit the home and look at the facilities of the home. The registered person, where necessary, seeks information from external healthcare professionals as part of the pre-admission assessment, to ensure the home is able to meet assessed needs. The staff interact well with the service users and treat them with respect. They give support in a sensitive manner. Comments from service users and relatives say: `They keep mum safe and risk free. The food is home cooking and the carers actually care about the residents`. `The staff have a friendly approach to all residents and their families`. `Everything is good about the home`. `All the residents are treated well and are well cared for. The staff are all caring and take the time to listen and give residents a lot of attention. They make the house a real home and there is always a family atmosphere when ever you visit`. `Having visited other care homes, Park House is clean and welcoming. They take time to make sure residents are occupied by entertainment in the home or on visits out. They all work hard`. The home has a comprehensive and appropriate training programme made available to all staff. Staff spoken to at the time of this visit and comments made on staff surveys returned to CQC said; `Training is available if needed. I can always approach the manager who will give me advice and is a good support`. `There is plenty of training made available to us and we get good support from the management team`. Staff expressed satisfaction with their roles and said on surveys; `The mood of service users and carers is always very good and staff team communicate well. The managers are very good and are easy to talk to if a problem arises`. `Park House delivers a high standard of care and succeeds in all aspects of the service which creates a fulfilling and happy job role`. `I really enjoy my job and this is the best place I have ever worked`. Health care is promoted through the home having developed good working relationships with healthcare specialists. The survey received from a visiting health professional stated that they were `happy with the care their patients receive`. Daily routines in the home are flexible and service users are encouraged to be independent and make choices within their daily activities of living. Service users made positive comments about the food and the meals the home provides and were generally pleased with the activities in which they could participate. The home maintains good health and safety records and ensures service users and staff are kept safe with minimal risks. What has improved since the last inspection? The care planning system is in the process of being changed and the new system is comprehensive and will provide person centred information about the needs of the service user and how they are to be met. The home had taken guidance from the Hampshire County Council Care Planning Support Officers. The environment has vastly changed and there have been big improvements in the environment. All but two rooms are single occupancy and all having en-suite facilities. The fixtures and fittings in the home are of a good standard and the rooms are very pleasant. The work on the building has not been quite completed and there is still some disruption in the home whilst this is being done. A number of profiling beds have been purchased for the comfort of service users. Medication policies and procedures are in place and staff have received medication training. More staff have been recruited and the proprietor has recruited a number of part time staff to allow the home flexibility when allocating shifts and therefore agency staff have not been used. The home now has an appraisal and supervision programme in place for all staff, which identifies their training needs and supports them in their role. What the care home could do better: The new care planning system to be completed for residents, which will give care staff the appropriate information of how service users wish their needs to be met in a more person centred way. There are still improvements to be made in the records for medication management. Two requirements are made from this report with regards to medication and two recommendations for good practice. A more structured activities programme be put in place in relation to people who have a dementia with records maintained of all activities that take place and stating individual`s level of participation. The quality assurance system could be more informative and records of all quality checks and audits be recorded. The outcomes from any of the surveys distributed to service users and other stakeholders should be analysed and record how this information will feed into an improvement plan for the home. The home will benefit from having a registered manager to lead the staff team and develop the service further. Key inspection report Care homes for older people Name: Address: Park House Rest Home 220 Havant Road Hayling Island Hampshire PO11 0LN     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: Janette Everitt     Date: 1 5 1 2 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 31 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Park House Rest Home 220 Havant Road Hayling Island Hampshire PO11 0LN 02392465274 02392765274 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Lee John Gosling,Ms SallyJayne Hoke Name of registered manager (if applicable) Mr Edward John OBrien Type of registration: Number of places registered: care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is: 16 The registered person may provide the following category ofservice only: Care home only- Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP), Dementia (Code DE), Mental Disorder, excluding learning disablilty or dementia (Code MD) Date of last inspection 16 16 0 Over 65 0 0 16 Care Homes for Older People Page 4 of 31 Brief description of the care home Park House is a detached residential care home situated within its own grounds, in a residential area of Hayling Island. The home is registered with the Care Quality Commission (CQC) to accommodate up to a maximum of 16 service users. The home benefits from a large rear garden and the front of the property is gravelled, with hanging baskets and flowers in the borders and provides parking for approximately 8 vehicles. The home is on a local bus route and the seafront at Hayling Island is within easy reach. The home meets the individual accommodation space requirements set out in the National Minimum Standards (NMS) 3rd edition for existing providers. For enquiries about fees contact the manager of the home. Care Homes for Older People Page 5 of 31 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 report details the evaluation of the quality of the service provided at Park House and takes into account the accumulated evidence of the activity at the home since the last inspection, which took place in December 2008. The Care Quality Commission made an unannounced visit to the home on the 15th December 2009. For this visit they were assisted for part of the inspection by the senior carer and the newly appointed manager. The registered person Ms Hoke attended the home later in the day. An Annual Quality Assurance Assessment (AQAA) had been completed by the home and the information from this and the last inspection report was used to inform this report. Evidence for this report was obtained from reading and inspecting records, touring the Care Homes for Older People Page 6 of 31 home and from observing the interaction between staff and service users. During this visit we spoke to most of the service users and both care staff and ancillary staff. In order to prepare for the visit, surveys were sent to the people living in the home, staff and other professionals involved with the home. Five service users, four staff and one health professional surveys were returned to CQC with comments that indicated a high level of satisfaction with the service delivered at the home. The home is registered to provide support for 16 residents and at the time of the inspection there were 14 people in residence, all but one were female. Care Homes for Older People Page 7 of 31 What the care home does well: What has improved since the last inspection? The care planning system is in the process of being changed and the new system is comprehensive and will provide person centred information about the needs of the service user and how they are to be met. The home had taken guidance from the Hampshire County Council Care Planning Support Officers. Care Homes for Older People Page 8 of 31 The environment has vastly changed and there have been big improvements in the environment. All but two rooms are single occupancy and all having en-suite facilities. The fixtures and fittings in the home are of a good standard and the rooms are very pleasant. The work on the building has not been quite completed and there is still some disruption in the home whilst this is being done. A number of profiling beds have been purchased for the comfort of service users. Medication policies and procedures are in place and staff have received medication training. More staff have been recruited and the proprietor has recruited a number of part time staff to allow the home flexibility when allocating shifts and therefore agency staff have not been used. The home now has an appraisal and supervision programme in place for all staff, which identifies their training needs and supports them in their role. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 31 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 10 of 31 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. Service users are fully assessed before they move into the home to live to ensure the home can meet their assessed needs Evidence: The AQAA returned told us the registered provider and manager carry out an individual needs assessment prior to clients moving to the home. A thorough assessment form is used to obtain as much information as possible from clients, family, representatives, social workers and hospital staff. The AQAA tells us that each new resident is given a preference questionnaire for them to complete to say what their preferences are on a large number of areas and issues and this information is incorporated into the care plans. A sample of four care plans were viewed. Three of the four contained a pre-admission assessment which covered all aspects of the persons care needs. There was also Care Homes for Older People Page 11 of 31 Evidence: evidence of a care managers care needs assessment in the files. Other information is also gathered from health care professionals and any professionals involved in the persons care prior to their moving into the home. The manager told us that relatives are invited to participate in the assessment process as a great deal of information can be gained from family involvement. The new manager has started to undertake the pre-admission assessments with the provider. Care Homes for Older People Page 12 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans for service users would enable staff to have the information they need to meet that persons needs. The health needs of service users are met with evidence of health professionals attending the home for consultation. The current medication procedures are now specific to the home and staff have received training however, there remains shortfalls in the medication record keeping. Staffs working practices help to ensure that the privacy and dignity of residents is promote Evidence: The AQAA told us that care plans for each service user are written on admission to the home and are easy to read and provide staff and health professional with relevant information and history about the client. The home has employed a person who is head of care planning and ensures that they are developed and reviewed accordingly. The home strives to continually improve the development of the care planning and together with the new manager take the team forward to deliver excellent care to clients. Care Homes for Older People Page 13 of 31 Evidence: The home is developing a new care planning system and is in the process of transferring all existing care plans over to the new system. This has been with the support of Hampshire County Council care planning support officer and is being headed by the new manager and the care planning co-ordinator. A sample of four service users care plans was viewed. The new system had been applied to one of those viewed. The new system when in place will be comprehensive and be more informative than the existing system. The manager told us it will take time to change all the documentation over. The current care plans do contain risk assessments for nutrition and tissue viability and do guide the day to day practices but are not detailed. Care plans were evidenced to be reviewed monthly and there was evidence that care plans are signed by the service user or their relative as evidence of their involvement. It was observed that for one service user who had bed rails in place there was a risk assessment but no evidence of a care plan to guide their use. There was no signed agreement for their use by the service user or any discussion with relatives about their use. This was discussed with the manager who said he would ensure that this was recorded in the future. It was observed that in the daily notes for one person, the language used by the carer was inappropriate and this was discussed with the manager and senior carer as being judgemental and the carer should be given training in using correct language in the reports. The AQAA told us that the home ensures that the service users have access to all their health care entitlements. For appointments transport is provided and an escort. There was evidence in the care plans of records of all health professionals that visited the service users and the outcomes from those visits. The manager told us that the home has good relationships with the local GPs, that visit the home. One survey returned from a GP commented that they were very happy with the care their patients receive in the home and that the home is very caring and makes very good assessments. The district nurse visits the home to dress wounds, take blood tests and give injections and to generally support the home when the home is caring for a person who is terminally ill. The local hospice is also very supportive of the home when they Care Homes for Older People Page 14 of 31 Evidence: are caring for a dying person. There was evidence in the care plans that the dentist will visit the home if needed. The optician and chiropodist visit the home regularly and the hearing clinic has also visited the home on an occasion. Service users spoken to told us that they see a doctor when they need to and receive the health care they need. The AQAA stated the safe handling, administration and storage of medicines has improved in accordance with the requirements made from the report of last year. The home has medication policies and procedures in place. The home now uses the Monitored Dosage system which is supplied by Boots. The pharmacist visits the home to offer advice and to collect the returns of unwanted medication. A record of which we viewed and observed to have been signed by the pharmacist. The medication system and storage of medication was viewed by us. The home has acquired a new medicine trolley that is attached to the wall in the corner of the lounge. A controlled drugs cupboard has also been fixed to the wall. The medication administration record (MAR) charts were viewed by us. These are generally completed appropriately. It was noted that for one service user, a medication was out of stock and therefore could not receive it as the pharmacist has not sent enough tablets to the home. There was no reason written on the back of the MAR why the service user had not received this medication. On another service users MAR it was signed to say they had received night sedation the previous night. The controlled drug (CD) register did not record that they had received this medication and it was noted that the medication had been withheld for the previous six days. This was discussed with the manager who said that a decision had been made with the GP to trial stopping the night sedation to see if the person had less falls. This information was not recorded in the care plans and it was not recorded who had made the decision to stop prescribed medication. The home does not view the prescriptions for the medication before it is sent to the pharmacist but it would be seen as good practice to check these before dispensing to ensure that everything the home needed and ordered was on the prescription and in the correct quantities. Care Homes for Older People Page 15 of 31 Evidence: It was noted that on a MAR chart some medication received between orders had been transcribed onto the MAR chart and not signed by the person transcribing or by a second person to witness that it had been copied correctly. This was discussed with the manager as safe practice for transcribed medication prescriptions to be signed and countersigned. All medication training is undertaken by the responsible person who has been the manager for the past year. She has been trained to deliver this training and will train and observe a carer before deeming them competent to administer the medications. We observed a care worker administering medication and this was being undertaken following safe procedures. The storage cupboards were viewed and were observed to be tidy and with no evidence of over stocking of any medications. At the time of this visit there were no service users choosing to manage their own medication but the manager said the service user would be risk assessed to do so, if they requested this. The staff were observed to be respecting the service users privacy and dignity and were addressing them courteously and knocking on bedroom doors before going into rooms. Care Homes for Older People Page 16 of 31 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. Service users participate in activities appropriate to their age, peer group and cultural beliefs as part of the local community. The residents are supported to exercise choice within their daily lives. Dietary needs are well catered for with a balance and varied selection of food available that meets individual dietary requirements and choices. Evidence: The home does not employ a designated activities co-ordinator but the manager told us that the homes staff arrange a programme of activities so that there is always something for the residents to look forward to. The home had planned a full programme of activities through the Christmas period and there was a party planned for that week. Service users spoken to said they were looking forward to the Christmas celebrations and that they were more than pleased with their beautiful Christmas tree that they and the staff had dressed during that week. There is no planned programme of activities advertised but the home has an activities book that records what activities take place and who has participated. This was viewed by us and had not been recorded as regularly as the manager told us that the activities take place. Care Homes for Older People Page 17 of 31 Evidence: The home has an activities folder that contains quizzes, games, puzzles and craft activities that are particularly suited to people with dementia. The service users told us that they had made Christmas cards the previous week and had enjoyed doing that. We also observed that Christmas decorations were being made by a group of service users during this visit. There was evidence in the record book that requested films are shown on the large television screen, service users can go out to walk with an escort. The home arranges various outings throughout the year and the manager told us that those service users who wish, have attended the theatre to see shows. Outside entertainers come to the home twice monthly for music therapy and exercises. Service user surveys returned to CQC indicated that there is usually some activities they can participate in, with a comment saying It would be better if we could have more afternoon entertainment and more day trips out. Another commented, the staff take time to make sure residents are occupied either by entertainment in the home or by visits away from the home. Social histories are recorded and are informative, but the home has asked families to provide them with a memory book for their relatives, outlining their past lives and what they enjoyed doing in the past and what might stimulate them in their old age. Relatives are invited to help and participate in all the arranged activities and many are willing to do so. Although the social activities are not tailored specifically around people with dementia the manager told us that in the coming year he will put together a mores structured programme of appropriate activities for those with dementia. The home is attended by two church clergy every month who provide worship and communion for those wishing to part take. Service users do go out into the community on outings and the home is regularly visited by a number of families who take their relatives on outings outside the home. Service users are always escorted on any hospital or community appointments by a family member or staff member. The home has employed a new chef in the past year. She was spoken to by us and said that she had refreshed the menus and created new dishes based on the residents likes and dislikes. She told us that she has received training in special diets and is currently only providing for two diabetic diets. The menu viewed offered good, Care Homes for Older People Page 18 of 31 Evidence: wholesome meals with a choice at every mealtime. The chef told us that the menus are around the service users preferences which are recorded on admission plus the knowledge she has gained by getting to know residents. Records are maintained of what residents have eaten. It was observed that service users are encouraged to eat their meals together in the dining area and they appeared to enjoy the social interaction with one another. The service users were spoken with following their lunch time meal. They reported that the food was very good and that they had enjoyed their meal. They also told us that the chef bakes all the cakes and they enjoy cake every day with their tea. Surveys returned from service users indicated that the food is very good and like home cooking and they have no complaints about it. Snacks and drinks are available throughout the whole day. A nutritional risk assessment is undertaken on service users who are presenting with risk and these assessments were evidenced in the care plans. Service users are referred to the GP if the risk increases. Service users are encouraged to make decisions for themselves and service users were seen wandering about and choosing where they liked to sit and what they did throughout the day. A number of service users enjoy staying in their room and this is respected. It was observed that some service users had brought with them personal items of furniture and personal belongings to individualise their rooms and this is encouraged when going to the home to live. Care Homes for Older People Page 19 of 31 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. The service has a clear and satisfactory complaints procedure that is available to all service users and stakeholders. Robust procedures are in place to protect service users from the risk of abuse. Evidence: The home provides a policy for dealing with complaints and this is held in the home and is accessible to all service users, visitors and staff. The AQAA stated that the home has not received any complaints in the last twelve months. The complaints log supported this with no complaints logged. The manager told us that it appears that service users and families are able to talk to staff about any issues freely before they become problematic. The service user surveys returned to CQC indicated that they would know who to talk to if they wished to complain. Service users spoken to at the time of this visit were very complimentary about their lives and did not have any complaints or issues they wished to discuss. The protection of vulnerable adults and the safeguarding policy and procedures are in place. Staff receive training in the safeguarding protocols and new staff are made aware of this at induction along with the Whistle Blowing policy. The manager and staff have received the training on the Mental Capacity Act and the Care Homes for Older People Page 20 of 31 Evidence: Deprivation of Liberty Safeguards. The responsible person Ms Hoke undertakes this training, having been trained to do so. The home has had no safeguarding issues in the last year. Care Homes for Older People Page 21 of 31 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. The environment has improved and now provides service users with a safe, clean and homely environment. However, currently the home is continuing the extensive alterations in the ground floor of the home for which risk assessments are in place. Evidence: We looked around the home. The report from last year said that at that time the home was undergoing some extensive building works and refurbishment. The AQAA tells us that the building works is nearing completion and this has provided all single en suite facilities for service users. The entire first and second floor have been refurbished and the areas are bright and clean. This building works is not yet complete but a large majority of the service users rooms are now single with en-suite facilities. The bathroom, wet rooms, laundry and office areas were in the process of being refurbished and completed at the time of this visit, therefore some of the ground floor still had building works in progress. A comment on a staff survey said We will all appreciate the new walk in shower that is being built they will be more user friendly and more accessible to the service users. It will also be good to have a designated staff area for our breaks. The bedrooms have been refurbished to a good standard and service users said they Care Homes for Older People Page 22 of 31 Evidence: were glad all the noise and dust had stopped and were very happy to show us their rooms. The responsible person told us that once the final building works are completed and ground floor hallways and stairs will be decorated. It was observed that the chair lift positioned on the first floor stairwell, the track protruded out and caused an obstruction at the doorway of a bedroom. This was discussed with the proprietors who said that there have been no problems with this do date but they would undertake a risk assessment of this and would state that the chair must be at the bottom resting position on the track when not in use so that the obstruction would be more apparent to anyone coming out of that room. The home has a detailed environmental risk assessment for the building works and home in general. The home was observed to be clean. Two housekeeping staff clean the home every day. The home has an infection control policy in place. The AQAA states that all staff have received training in the principles of infection control and it was observed that there was hand washing facilities in all bathrooms and toilets and staff were seen to be wearing appropriate protective clothing whilst undertaking specific tasks. Staff surveys returned to CQC indicate that they have received all the mandatory training they need to enable them to do their job properly. One staff comment said hygiene is an important part of very day care so we are encouraged to use clean gloves and aprons when dealing with each person. Care Homes for Older People Page 23 of 31 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. Service users have their needs met by staff that are trained, supportive and sufficient in numbers. The recruitment practices are more robust and protect the service users. Evidence: The staffing rotas evidenced that for the fourteen service users in residence there were two carers on duty in the morning of this visit with the senior carer and the manager. The two proprietors attend the home daily. The rotas show that there is always three care staff on duty throughout the day and one awake and one sleeping carer at night. From observations of the staff working and talking to service users at the time of this visit, this complement of staff appears sufficient. Service user surveys returned indicated that staff were always available when they were needed and indeed there was a constant staff presence in the lounge area. Comments on surveys returned from service users said All residents are treated equally and are well cared for. The staff are caring and take time to listen and give us a lot of attention, they make the house a real home and there is a family atmosphere. They keep us safe and the carers actually care. Care Homes for Older People Page 24 of 31 Evidence: The home employs a separate housekeeping staff who attend the home seven days a week.-The home has a gardener and one of the proprietors undertakes all maintenance repairs and the other does the cooking at the week-ends. There has been a noticeable increase in the staff recruitment in the past year and the proprietor told us that she now has a very good staff team that work well together and are flexible. The home provides a training programme for all staff. The AQAA tells us that three of the fourteen care staff have achieved the national vocational qualification (NVQ) at level 2 and 3. The proprietor told us that four more staff are waiting to commence their NVQ training in the New Year but there have been problems in the area in obtaining an appropriate training supplier. The staff have undertaken various training courses and the proprietor has undertaken appropriate train the trainer courses to enable her to deliver the training for dementia, moving and handling, medication, infection control, continence management and safeguarding. The home has a training matrix for each staff member and these evidenced that staff have received all the mandatory training during the past year. The training needs of staff are identified during the yearly appraisal and regular supervisions that take place. Records of this were seen and the manager said nearly all of the yearly appraisals have been undertaken. A sample of three recruitment files was viewed. These demonstrated that all the appropriate Criminal Record Bureau (CRB), and the Protection of Vulnerable Adults clearance had been received by the home before the person commenced employment. References were seen and records of the induction programme were also evidenced. Care Homes for Older People Page 25 of 31 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 home is being managed by a person who has experience but is not registered. The home is run in the best interests of the service users, however, the quality assurance system is to be developed. Service user finances are protected. The health and safety of the service users and staff are promoted and protected Evidence: The home has been without a registered manager for a year. The responsible person and proprietor Ms S Hoke, has been managing the home in that year. A new manager has now been appointed and has commenced working at the home and assisted us with this visit. He has experience in the care industry and also in teaching. He will be applying for registration with CQC when all appropriate documentation is completed. He had yet to commence his management and leadership course. Care Homes for Older People Page 26 of 31 Evidence: The manager told us that the home has a quality assurance system in place to monitor the standards and the level of satisfaction of the service users. Questionnaires have been distributed to service users, staff and other stakeholders but the results were not available at this time owing to the surveys return date being the end of December. The care plans are audited by the senior carer designated for this and MAR charts are checked weekly along with a drug audit. The cleanliness of the home and the general maintenance of the home are checked daily. There was no structured documentation to demonstrate what audits take place. The home does store some service users monies for them to buy personal items of their choice. Three of the monies and records were checked by us and were found to be recorded well. All monies are stored individually and each having a record of incoming and outgoing monies and all receipts for monies spent. The monies being stored balances with the amount stated on the records. The home has a comprehensive risk assessment and all service users have individual risk assessments. The fir log was viewed and demonstrated that systems and equipment were serviced and checked at appropriate intervals. A fire risk assessment was also in place. The training matrix evidenced that staff had received all the mandatory training and this includes fire training from an outside fire trainer. Eight staff are appointed first aid trained. A sample of servicing certificates were viewed and these demonstrated that equipment and systems have been serviced and checked within appropriate timescales. The cleaning materials and COSHH chemicals were observed to be kept in a locked environment and it was observed that the cleaning materials were not left unattended by the housekeepers. Care Homes for Older People Page 27 of 31 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 28 of 31 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 You are required to ensure 31/01/2010 that a clear record is maintained of reasons for withholding medication or any changes in prescribed medication and who gave these directions or instigated these changes. This must be done to ensure that all prescribed medication is administered and reasons for witholding or changes to prescribed medication must be clearly recorded in the service users notes. 2 9 13 You must ensure that if prescribed medication is not administered, the reasons for this are clearly documented on the MAR chart. This must be done to ensure that service user are given their prescribed medication 31/01/2010 Care Homes for Older People Page 29 of 31 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 and reasons for this not being administered must be clearly stated on the MAR chart. 3 33 24 You must ensure that a quality assurance system is in place for reviewing at appropriate intervals the quality of care and for improving the service. The results of any quality assurance monitoring must be analysed and recorded to ensure the service is meeting the stated aims and objectives as stated in the Statement of Purpose. 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 01/03/2010 1 9 It is recommended that any prescribed medication that is transcribed onto the MAR charts be signed by the person transcribing the prescription and who should ensure that another person countersigns this as evidence of accuracy Care Homes for Older People Page 30 of 31 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 31 of 31 - 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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