Care Home: Park Lane House

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What the care home does well Park Lane House presents with a very warm, caring and friendly environment and residents appeared relaxed and comfortable with the staff. It was evident through interviews, general observations and discussions that staff had a good knowledge of the residents’ individual care needs and the level of support required. During our visit staff were observed spending a great deal of time with residents either on an individual basis or within a group. Care was seen to be given in a discreet sensitive manner and staff were patient and gentle in their approach. Feedback from residents and relatives was very good, comments regarding the service included: “Very good home” “Lovely staff” In the main, residents were satisfied with the support they were given and described staff as “nice people”, “lovely”, “find time to listen” and “good fun and very efficient”. A relative we spoke with said “the staff give excellent care for mum and me in the most thoughtful manner” Prior to admission the manager or deputy manager assesses residents’ health and social needs. Information collated is then used to the form the basis for the plan of care. Assessment documentation seen had been completed to good standard and included key areas regarding the residents’ health and general well being. Care files were organised, the information easy to read and care plans identified the relevant care and support required. Attention is paid to recording basic needs, such as dental, optical, hearing and foot care, which are so important to the care of an elderly person. Comments regarding the care included: “Excellent care” “Absolutely excellent” “Most helpful care and support” Residents interviewed confirmed that the daily routine was flexible and based very much around their wishes. A resident said, “The staff never mind what time I go to bed, they are very accommodating”. Other residents commented on the fact that they can choose what to do during the day and that there is always ‘something going on’ which they like. Staff have access to a very good standard of training in safe working practice areas to ensure they have the skill and knowledge to provide the care and support needed. Over 90% staff are qualified to a (NVQ) National Vocational Qualification Levels 2 and 3 in care. Park Lane House DS0000005515.V375888.R01.S.doc Version 5.2 The management of the home is of a good standard and the manager was able to demonstrate a sound understanding and knowledge of the home’s quality assurance processes. The owner and the manager have an understanding of the areas in which the home could further improve. The details of how they were going to achieve these improvements were provided in the AQAA. What has improved since the last inspection? All of the requirements and recommendations following the last key inspection have been met. Care documentation for residents has greatly improved to reflect individual care and social needs. A requirement was raised regarding this at the last inspection and the new manager has made more improvements to ensure staff deliver care in a flexible, consistent and reliable way. Training in the protection of vulnerable adults has been made available for all of the staff. What the care home could do better: There is still a large amount of work outstanding in respect of making the home a pleasant and well maintained environment. The work includes decoration and some remedial work, including level flooring and carpeting. The outside of the building requires plaster work and painting as well as replacement windows. Good practice recommendations are made in the main report to implement best practice and improve the overall service. Key inspection report CARE HOMES FOR OLDER PEOPLE Park Lane House Off Rochdale Lane Royton Oldham OL2 5QX Lead Inspector Bernard Tracey Unannounced Inspection 11th June 2009 08:00 11/06/09 DS0000005515.V375888.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 Lane House DS0000005515.V375888.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 Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park Lane House Address Off Rochdale Lane Royton Oldham OL2 5QX 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) 01616243697 F/P 01616243697 Dr Saphal Kanti Pal Ms Samantha Lorraine Pal Susan Murphy Care Home 16 Category(ies) of Dementia (16), Old age, not falling within any registration, with number other category (16) of places Park Lane House DS0000005515.V375888.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 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 The maximum number of service users who can be accommodated is: 16 Date of last inspection 15th June 2007 Brief Description of the Service: Park Lane House is a privately owned care home, which is registered to accommodate 16 people. The home is situated close to Royton centre and is within easy reach of shops, community facilities and a local market. The building is a detached property with pleasant gardens to the front and limited car parking space to the rear. Accommodation for residents is provided on the ground and first floors of the building. A passenger lift has been installed between these two floors and ramped access has been provided externally. There are sixteen single bedrooms, twelve of which have en-suite toilet facilities. The home charges £360 each week. The previous inspection report is available on request. Park Lane House DS0000005515.V375888.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 stars. This means the people who use this service experience Good quality outcomes. The last key inspection on this service was completed on the 15th June 2007. In February 2009 we undertook an Annual Service Review. This is a report that we write for good or excellent services that have not had a key inspection in the last year. It does not routinely include a visit to the service. The review is an analysis of all the information that we have gathered about the service since the last main inspection. We (the Care Quality Commission) undertook this key inspection, which included an unannounced visit to the home. The staff at the home did not know the visit was going to take place. This visit was just one part of the inspection. We also looked at other information we had about the home. The manager was asked to fill in a questionnaire, called an Annual Quality Assurance Assessment (AQAA), telling us what they thought they did well, what they need to do better and what they have improved upon. Where appropriate, these comments have been included in the report. We sent our questionnaires out to people who live in the home and staff in order to find out their views. Other information we had received since our last major inspection at the home was also reviewed. We spent 5.5 hours at the home over one day. During this time, we looked at care and medicine records to ensure that health and care needs were met and also studied how information was given to people before they decided to move into the home. A tour of the building was undertaken and time was spent looking at records regarding safety in the home. We also examined files that contained information about how the staff were recruited for their jobs, as well as records about staff training. We spent time speaking to five residents and a visitor as well as speaking to two staff, the owner, manager and the deputy manager. We have received no complaints about the service since our last key inspection. Park Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 6 What the service does well: Park Lane House presents with a very warm, caring and friendly environment and residents appeared relaxed and comfortable with the staff. It was evident through interviews, general observations and discussions that staff had a good knowledge of the residents’ individual care needs and the level of support required. During our visit staff were observed spending a great deal of time with residents either on an individual basis or within a group. Care was seen to be given in a discreet sensitive manner and staff were patient and gentle in their approach. Feedback from residents and relatives was very good, comments regarding the service included: “Very good home” “Lovely staff” In the main, residents were satisfied with the support they were given and described staff as “nice people”, “lovely”, “find time to listen” and “good fun and very efficient”. A relative we spoke with said “the staff give excellent care for mum and me in the most thoughtful manner” Prior to admission the manager or deputy manager assesses residents’ health and social needs. Information collated is then used to the form the basis for the plan of care. Assessment documentation seen had been completed to good standard and included key areas regarding the residents’ health and general well being. Care files were organised, the information easy to read and care plans identified the relevant care and support required. Attention is paid to recording basic needs, such as dental, optical, hearing and foot care, which are so important to the care of an elderly person. Comments regarding the care included: “Excellent care” “Absolutely excellent” “Most helpful care and support” Residents interviewed confirmed that the daily routine was flexible and based very much around their wishes. A resident said, “The staff never mind what time I go to bed, they are very accommodating”. Other residents commented on the fact that they can choose what to do during the day and that there is always ‘something going on’ which they like. Staff have access to a very good standard of training in safe working practice areas to ensure they have the skill and knowledge to provide the care and support needed. Over 90 staff are qualified to a (NVQ) National Vocational Qualification Levels 2 and 3 in care. Park Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 7 The management of the home is of a good standard and the manager was able to demonstrate a sound understanding and knowledge of the home’s quality assurance processes. The owner and the manager have an understanding of the areas in which the home could further improve. The details of how they were going to achieve these improvements were provided in the AQAA. What has improved since the last inspection? 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. Park Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 8 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 Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 9 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) People using the service experience good quality outcomes in this area. Detailed assessments are undertaken before people come into to the home so they can feel confident that their needs can be met. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The admission arrangements for new residents were very thorough. This ensured that the home would be a suitable placement for that person and would be able to meet their assessed needs. Initial enquiries were recorded and followed up by a visit to the individual, either in their own home or, more commonly, in hospital, to complete a detailed assessment of their needs. The manager liaises closely with family members and any health care professionals involved with the prospective resident. This helped the manager to build up a full picture of the person’s Park Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 10 needs. The assessment included personal and healthcare needs, as well as social care and behavioural needs. The manager generally conducted preadmission assessments. All residents had a contract in their personal file, either signed by the individual or, in some cases, their representative. Park Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 11 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 10 People using the service experience good quality outcomes in this area. Residents’ health and personal care needs are being met and are addressed in detailed care plans. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Individual records are kept for each resident and contain comprehensive information relating to all aspects of health, personal and social care needs of the residents. From this information an individual plan of care is drawn up with the involvement of the resident or their relative to ensure that the care needs are met. Significant events had been recorded and daily entries made setting out the care given. Risk assessments were in place and covered such areas as moving and handling, nutrition, pressure sores, the use of bed rails and falls. Park Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 12 Risk assessments and the care plans were evaluated as and when required but at least on a monthly basis, though we noted that the reviews had not taken place in the preceding month. The residents were weighed in accordance with their nutritional risk assessment but at least on a monthly basis and the weight recorded on a chart kept in their care plan. A relative survey stated “The residents are very well cared for. The staff are very pleasant and approachable if I need to ask them anything. The residents are very clean and are all well cared for personally and individually.” Three residents spoken with confirmed that they feel well looked after and were happy with the care they were receiving. One resident told us that “the care I have received sine coming here is second to none.” There is an efficient Medication Policy supported by procedures and practice guidelines. Staff follow robust systems to make sure that medication records are fully completed, contain required entries and are signed by appropriate staff. Hand transcribed medication should be witnessed by two members of staff to avoid mistakes being made. Staff were observed delivering care in a sensitive and respectful manner: addressing residents by their preferred name; knocking on doors and enabling residents to maintain as much independence as possible. The home tries to gain as much information about a person’s past as possible, and staff were seen to use this information to engage with individuals and initiate discussion. Examination of 3 care files identified that the residents had access to health care professionals, such as dentists, opticians, chiropodists and district nurses. Equipment necessary for the prevention and treatment of pressure sores, such as special mattresses, was readily available within the home. Park Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 13 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 15 People using the service experience good quality outcomes in this area. Social activities provide daily variation and interest for people living in the home. The dietary needs of the residents were well catered for with a balanced and varied selection of food being served. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The resident’s involvement in social activities varies greatly according to their abilities and needs. Some of the residents spoken to preferred to stay in their own bedrooms and enjoyed reading, listening to music and watching the television. The home has a very pleasant friendly atmosphere and staff give a great deal of thought to arranging social activities to suit individual needs and preferences. Social needs are assessed in detail when a resident is admitted and residents spoken with were pleased with the home’s varied programme of Park Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 14 social events. Staff work hard to ensure social interests are stimulating and it was evident through discussion with a number of residents that they enjoy a lifestyle that meets their preferences. In the AQAA we were informed that an activity person is responsible for organising a programme of activities. . In our discussion with the residents and care staff we confirmed that the residents were able to receive visitors in private and that they were able to choose whom they see and do not see. Visitors can be seen in the privacy of the residents’ bedroom although many choose to sit in one of the communal areas. Residents are encouraged to bring personal possessions into the home. Many of their bedrooms were highly personalised with small pieces of their own furniture, pictures, photographs and ornaments etc. We did not dine with the residents but observed lunch being served in the dining room. The meals served were of ample portion and looked appetising. Staff discreetly assisted some residents to eat. Comments regarding the food included: “The meals are served nicely” “You could not have better “Very good food” “Such a good choice” “Excellent meals” There was always a choice of meal at lunchtime and evening. The menus were inspected and they looked varied and nutritious. Mid-morning and midafternoon drinks were served and milky drinks were provided at suppertime. A discussion with the residents showed that they were very happy with the choice and quality of the food provided. Park Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 15 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. There is a clear complaints procedure and residents know action will be taken to resolve their concerns. Staff have a good knowledge and understanding of Adult Protection issues which safeguards residents from abuse We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The complaint policy is displayed for residents or their relatives to view. Residents interviewed had no concerns at this time and reported that they would speak to the manager if they were at all unhappy. A relative said that if he had cause to complain then he felt confident that the staff would listen and help to resolve any issues Minor complaints are not logged and we suggest that this should be carried out so as to help the manager and the owner to audit issues that arise in the home. A staff member interviewed said that they knew what procedure to follow should a resident wish to make a complaint. There is a copy of the Oldham Guide for the Protection of Vulnerable Adults in the home and the majority of the staff have undertaken training in relation to Park Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 16 the Protection of Vulnerable Adults, with evidence of further planned training in this aspect of care. The home also has an abuse policy and whistle blowing procedure. The staff training record evidenced abuse awareness training for a number of staff with more training places booked and staff interviewed had an understanding of how to report an alleged incident. Park Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 17 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): 19,25 & 26 People using the service experience adequate quality outcomes in this area. Whilst some areas of the home are acceptable, the environment on the whole is neither homely nor well maintained We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: A tour of the communal and private areas of the home was completed. A significant number of bedrooms had been personalised with items chosen by the service users or brought from their homes. In the main rooms were clean and free of unpleasant odours. There has been a lack of investment in the home to ensure that the building and accommodation is well maintained. Day to day remedial repairs have been identified by the manager of the home but have not been attended to by the Park Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 18 Registered Provider. The provision of a maintenance/handyman would ensure that routine repairs were completed in a timely fashion and larger routine repairs and maintenance could be planned on a yearly basis. We found that minor, but essential, repairs were taking up to 4 months to be remedied with some repairs that were identified in January of this year still not attended to. These include bedroom door not closing, taps in resident wash basin loose and a door handles that needs replacing. A ceiling rose was missing in the shower area with electrical wiring visible. Larger piece of work such as a toilet that needs tiling is also outstanding. The corridors are sparse and would benefit from a programme of decoration with prints and pictures replacing the health and safety notices that are presently displayed as this gives a rather institutional feel to the public areas. The outside of the building requires a major facelift as well some essential replacements of window frames and double glazed units that have ‘popped’. There are large areas of plaster missing from some parts of the outside walls and these require rendering and the building needs re painting. The car park wall has collapsed and needs replacing as it is a safety hazard. The rear of the building needs to be cleared of overgrown weeds and the perimeter fence needs repairing. A trip hazard was identified on the ground floor corridor exit opposite the laundry where there was quite a significant dip in the floorboards. We discussed this with the manager during our visit and stressed that remedial action must be taken to address this. The manager has been asked to conduct a full environmental audit and submit a maintenance and development plan to the Commission in response to the deficits noted in our inspection. Park Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 19 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 & 30 People using the service experience excellent quality outcomes in this area. The staff team had collective skills training and expertise to undertake their roles effectively and good recruitment and selection procedures were in place to ensure that the residents were protected. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Staffing levels within the home were seen to meet the needs of residents. Care staff undertook their duties in a friendly and caring manner, promptly supporting residents’ when needed. Residents confirmed that staff were always respectful and met their needs competently. In the main, residents were satisfied with the support they were given and described staff as “nice people”, “lovely”, “find time to listen” and “good fun and very efficient”. A relative we spoke with said “the staff give excellent care for mum and me in the most thoughtful manner” Park Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 20 Three staff files were viewed with regard to recruitment practices and these contained all of the necessary checks to protect the residents. Staff had completed a job application form and two references had been obtained. Staff files contained a POVA Protection of Vulnerable Adult check and Criminal Record Bureau disclosure at enhanced level. The necessary checks are in place prior to staff commencing work and the interviewer completes an interview checklist. Individual staff training records provided a clear summary of both induction and ongoing training. This was extensive and wide ranging, with mandatory courses, i.e., moving and handling, medication, fire safety and first aid. Specialist training included care planning, risk assessment, mental health and Dementia. This training package was confirmed by the manager and was identified in the written AQAA she had provided us with. Similarly, staff who were interviewed confirmed that training was available, that they were encouraged to attend and that it gave them appropriate competencies to meet the needs of the residents. A staff member commented, “the training here is excellent”. Park Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 21 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 & 38. People using the service experience good quality outcomes in this area. The registered manager provides guidance and support to staff, ensuring that the residents receive a consistently good standard of care. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The manager has the required qualifications and experience, and is competent to run the home. There is a strong emphasis of being open and transparent in all areas of running of the home. The manager and staff work hard to make sure that everyone feels they are included in decision-making and feel valued as an individual. Park Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 22 There is a good system in place to gather staff, residents and relatives’ views through regular meetings and satisfaction questionnaires as part of the monitoring of quality. The manager achieves this by sending out surveys to residents and relatives asking for their views on the friendliness of the staff, the care provided, the laundry service, the meals provided, social activities and the cleanliness of the home. Staff spoken to have a clear understanding of their role and what was expected of them. Documentation was examined that confirmed that staff received regular supervision and annual appraisal. Residents and visitors spoke well of the management team and the care and support that they give. During our visit we were able to witness their approach to the residents and staff and confirm the comments made. Comments made included: There is an open door policy. All of the staff have a good team spirit. Relevant training sessions are provided. Good induction and support for newcomers Information provided by the manager in the AQAA and examination of the records, confirmed that all safety equipment is regularly serviced. We confirmed this through examining a random sample. There was no Electrical Circuit certificate which is required to be updated every 5 years and the need to ensure that the electrical equipment is safe is a requirement of this report The policies and procedures in the home ensure that the health, safety and welfare of the residents and staff are promoted and protected. The system for the safekeeping of residents’ finances was good. Individual records are made of all transactions and balances. Receipts are held for any purchases made and receipts are given to relatives when they deposit any “spending money” for their relative. The Annual Quality Assurance Assessment (AQAA) requested Commission was returned in time and was completed in detail. by the Park Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 23 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 X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Park Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 24 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. 1. Standard OP19 Regulation 23 (2) Requirement A programme, with timescales, to detail how the required maintenance and decoration of the home must be forwarded to the Care Quality Commission. This will ensure that residents can be confident that they are living in a safe well maintained and comfortable environment. The uneven surface in the corridor leading to the laundry must be filled in so that residents will not trip and fall. The missing tiles on the toilet walls, ground floor, must be replaced, so as to lessen the risk of infections spreading. Timescale for action 30/08/09 2. OP19 13(4)(a) 30/08/09 3. OP19 23 (2) (b) 30/08/09 Park Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 25 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. 2. 3. 4. 5. 6. Refer to Standard OP9 OP7 Good Practice Recommendations Hand transcribed medication should be witnessed by two members of staff to avoid errors Entries made into the daily notes should be timed as well as well as dated to ensue that entries are accurately recorded A record of minor complaints should be maintained to help the manager in her quality assurance audits. It is recommended that the re-decoration of the home and replacement of worn carpets be continued as planned. It is recommended that the refurbishment and redecoration of all toilets and bathrooms be continued as planned. An electrical safety certificate should be obtained to demonstrate that the wiring in the building is sound. A copy of the electrical certificate for the service should be forwarded to Commission OP16 OP19 OP19 OP38 Park Lane House DS0000005515.V375888.R01.S.doc Version 5.2 Page 26 Care Quality Commission North West 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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