Care Home: Park Mount

What the care home does well The booklet that tells people how the home works, called the service users` guide, is clear about what is provided there and people`s care needs have been checked before they move into the home so they know their needs can be met at Park Mount. The staff team is well established and staff are keen for high standards to be maintained so that people living there received good quality care. Day to day supervision of staff is good and they receive regular formal supervision so that they get good support from their line manager to make sure they can provide good care for the people who live at Park Mount. The manager is competent and well qualified and she makes good use of information gathered through the quality assurance processes, showing that the views of the people who live in the home are important and taken into account in planning developments at the home. Plans of care are individual and the case notes for people who live in the home were well documented so that the staff know what they should do to meet people`s needs. Referrals to appropriate health care professionals take place when necessary to make sure that people living in the home stay well and as healthy as possible. People who live in the home said, "I like living here", "the staff are excellent", "the food is good" and "the home is kept very clean and tidy". Staff said, "the management team listen to all people`s needs and try and help to the best of their ability. They get help off other services from outside", "they try and make it a good home and the training is updated regularly", "I think it is a lovely home and would live here if I needed to" and "they deliver good care fore each individual and understand each persons` needs and preferences and these are always taken into account". Other comments included, "training is very good and the service always takes residents needs into account and that their needs are met. The manager is easy to talk to and is always ready to listen to what we have to say", "all the service users are encouraged to consider the house their new home. Each persons birthday is special with the home providing flowers, a card and cake for them", "we provide a good, caring and supportive home for the residents and their families" and "in my opinion the residents are well cared for and the manager is very supportive". What has improved since the last inspection? Medication is now stored securely and risk assessments undertaken are thorough to ensure that people who live at Park Mount are protected from unnecessary risks. What the care home could do better: We have made a number of recommendations for minor improvements to some of the recording and systems at the home to help make sure that these accurately reflect what is happening to the people who move in and live at Park Mount.Although the gas installation has been recently checked an appropriate certificate should be obtained so that documentary proof of the work is available for inspection purposes. Also accident books should be obtained so that records are written and stored in line with Data Protection Act legislation. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Park Mount 52 Park Mount Drive Macclesfield Cheshire SK11 8NT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Maureen Brown     Date: 0 6 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Park Mount 52 Park Mount Drive Macclesfield Cheshire SK11 8NT 01625616459 01625869080 pallottine.sisters@virgin.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Pallottine Missionary Sisters care home 30 Number of places (if applicable): Under 65 Over 65 30 old age, not falling within any other category Additional conditions: 0 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. The maximum number of service users who can be accommodated is: 30. Date of last inspection Brief description of the care home Park Mount Care Home is a purpose built home set in two and a half acres of mature grounds. There is accommodation for thirty people in single en-suite rooms on two floors. There is a passenger lift. There is a chapel in the home where regular services are conducted and all denominations are made welcome. The current scale of charges is 420.00 pounds per week. The latest inspection report can be obtained from the manager of the home. Care Homes for Older People Page 4 of 26 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: We carried out an unannounced visit to the home on 6 May 2009 and the visit lasted eight hours. It was done by one inspector. The report will say we when referring to what was done and found at this visit as it is written on behalf of the Care Quality Commission. This visit was just one part of the inspection. Before the visit the manager was asked to complete a questionnaire to provide up to date information about the service. We sent out questionnaires to people who use the service and the staff team to find out their views about the agency and the service provided. Other information received was also reviewed. Care Homes for Older People Page 5 of 26 During our visit we looked at various records and the premises. We looked at the care records of a number of people who live at the home, to see how their needs were being met. We spoke with a number of people who live at the home , the manager, the provider and staff members and they all gave their views about the home. What the care home does well: What has improved since the last inspection? What they could do better: We have made a number of recommendations for minor improvements to some of the recording and systems at the home to help make sure that these accurately reflect what is happening to the people who move in and live at Park Mount. Care Homes for Older People Page 7 of 26 Although the gas installation has been recently checked an appropriate certificate should be obtained so that documentary proof of the work is available for inspection purposes. Also accident books should be obtained so that records are written and stored in line with Data Protection Act legislation. 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 set out 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 8 of 26 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 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive enough information about the home for them to make an informed decision about moving into the home and their needs are assessed before they move in so they know these can be met. Evidence: The information that tells people how the home works and what it provides is put into the residents guide for the home. This booklet is written in plain English and contains information about the aims of the home, what facilities it provides, terms and conditions of residence and information about how to obtain the latest inspection report. Also included was the complaints procedure, details of the manager and provider and the charges for living there. It was recommended that this document be developed to include pictures and the review date and produced in other formats, such as large print and audio versions to help people to understand it more easily. Care Homes for Older People Page 10 of 26 Evidence: The document used by staff at the home to check people;s care needs before they move into Park Mount is thorough and would enable the staff to gather all the information they would need to make sure the persons needs could be met. We recommended that this should be signed and dated by the person completing it so it was clear who had done the checks and when. The manager confirmed that intermediate care was not provided at Park Mount. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health, personal care and social needs of the people living in the home are met effectively by the staff team in a way that enables them to maintain their privacy and dignity. Evidence: We looked at the care plans of three people who live at Park Mount, to check on the care they receive. The care plans were well written and each file was well organised so that it would be easy for staff to find any information and guidance they might need. We suggested that a photograph of the person whose care file it was should be included in each file so that staff and others know who they are reading about. Also, if a person were to go missing, an accurate photo of them would be available. The daily records made by staff about each person were good and were completed twice a day. Staff noted any changes to people, activities they had taken part in details of visitors were also recorded so that staff and others could see that people were well and active. Care Homes for Older People Page 12 of 26 Evidence: All the files we saw had reviews which had been completed in April 2009 and these made sure that the information was up to date and still effective. Some of the people in the home were not able to confirm that they had been involved in the planning or reviewing of their care but they did confirm that staff helped them when they needed it. Risk assessments were included in the care plans. These were up to date and had been carried out for moving and handling, oral health and nutrition. The risk assessments were completed to make sure that people were safe in their daily activities and that any help they might need was identified. The medication is stored securely; it is a monitored dosage system provided by the local pharmacy. Medication administration record sheets are used by the staff when they give people their medication. Medication training is completed to ensure that staff who give out medication know how to do it safely so that errors do not happen. The home also has policies on people taking care of their own medicines, use of a monitored dosage system, use of common or homely remedies, management of errors or incidents in the administration of medication, control of medication policy and drug administration and disposal. Visits people living at the home had with health care professionals were recorded and it was seen that GPs, district nurses, chiropodist, optician, dentist and consultants visited the home regularly to make sure people remain well. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were able to take part in a range of activities so they can stay active and staff help people so they could stay in touch with their family and friends. Evidence: One of the senior care assistants has taken on the role of activities co-ordinator as part of her role. People who live at Park Mount have access to a range of activities that include quizzes, exercises, ball games, film shows, card games, sing a longs, dominoes and board games. Entertainers come into the home regularly and some people who live there go out shopping and out and about in the local community. A barge trip was being planned for the summer. The home has its own chapel where services are held and people can attend if they wish to. A record is kept of the activities undertaken by the people who live in the home to check whether they are taking part in social activities and keeping active. People who live at the home were offered choices in various ways, such as in the time they get up or go to bed, by choosing which clothes to wear, by deciding whether or not to join in activities and by deciding how they wished to be addressed. This enables Care Homes for Older People Page 14 of 26 Evidence: them to keep some control over what they do each day and to stay as independent as possible. We looked at samples of menus. The menus are produced on a six weekly basis and these were reviewed in March 2009. These showed a diet of popular and mainly traditional dishes. The main meal was provided at lunch time and consisted of soup, hot main course and dessert. The cook told us that peoples likes and dislikes were well recorded and if a person did not like the main course for the day, they could have an omelette, fish fingers or poached fish as alternatives. She also said that she knows which people are diabetics and those who prefer a soft diet. She said that for people who were on a soft diet, she blended the meal together. We suggested that each part of the meal should be blended separately so that the person may choose which parts of the meal they put together or not. The cook agreed that this would be possible to do in the future and it would also look much better. There are drinks and snacks available in between the usual mealtimes. People spoken with after the meal said they had enjoyed the meal and that the food is very good. The cook was fairly new in post and said that she had received a lot of support from people who work at the home and the manager, and that she had been made to feel really welcome. Care Homes for Older People Page 15 of 26 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 homes procedures for complaints and safeguarding adults are effective so that the concerns of people who live at Park Mount are listened to and they are protected from abuse and harm. Evidence: The staff files we checked during our visit to the home showed that staff had completed training on safeguarding adults from abuse. The manager confirmed this and showed that she was aware of the policy, procedures and guidance of safeguarding. There were also policies available on safeguarding adults, bullying in the workplace, management of challenging behaviour, whistle blowing and the local authoritys No Secrets policy. This provided guidance for staff so they would know what to do to make sure that people living at the home were protected from harm and abuse. No referrals had been made since our last visit from the home under the local safeguarding adults procedures. The complaints procedure was satisfactory and contained details of how to contact the commission. We have not received any complaints about this home since our last inspection there. The home had not received any complaints either. People who live at Park Mount told us they would contact the manager if they had any problems. Care Homes for Older People Page 16 of 26 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 home is well maintained so that people who live at Park Mount live in clean, safe and comfortable surroundings. Evidence: During our visit we walked round the home. We saw all the shared (communal) areas as well as a number of bedrooms. All the bedrooms are en-suite and some rooms were adjoining to provide a bedroom and sitting room for couples who wished to remain together. The standard of decor and furnishings was good and the home was clean and odour free. People who live at Park Mount had made their rooms more homely by using ornaments, pictures, photographs and some furniture they had brought with them when they moved in. It was suggested that signs be added to the doors for toilets, bathrooms and the office so that people could find them more easily. People who live at the home said they liked their bedrooms and The home is always clean and I like my room very much. Care Homes for Older People Page 17 of 26 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. The recruitment procedures are thorough and staff have done a wide range of training so people who live in the home are protected from poor practices. Evidence: The staff rotas showed the number of staff on duty over the week. The staffing levels appeared to be sufficient to meet peoples needs. People who live in the home confirmed there were enough staff around to help them and during the visit we saw that staff were attentive to peoples needs. The care staff team are supported in their work by cooks, domestic staff and a maintenance person. We looked at three staff records. They had all the necessary pre-employment checks in place including identity checks, Criminal Record Bureau checks, application forms and health checks. All the staff had two references except for those who had been employed by the home for a long time when it was usual practice to only obtain one reference. It was suggested that a statement be added to these peoples files to show why only one reference was available. The mandatory training staff had completed included moving and handling, fire awareness, food handling, and abuse awareness. Specialist training included health and safety, infection control, medication, mental health training, dementia awareness Care Homes for Older People Page 18 of 26 Evidence: and Parkinsons awareness. The manager said that planned training for the next year included food handling, first aid, fire awareness and medication awareness. Excellent progress has been made with NVQ level 2 training. Twenty-seven out of thirty-one staff had obtained NVQ level 2 or 3. This means that a good percentage of staff have a nationally recognised qualification in care to help them provide good quality support for the people who live in the home. Care Homes for Older People Page 19 of 26 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 procedures within the home are thorough so the health, safety and welfare of the people who live there are protected. Staff are well supervised and there are processes in place to make sure the home is run in the best interests of the people who live there. Evidence: The manager has worked at the home for four years and has eighteen years experience in care home management. She holds the registered managers award and has kept up to date with her professional knowledge and relevant courses. She knows the service well and can make sure that it is run well for the people who live there. There is an established quality assurance process for the home which includes staff and resident meetings, monthly visits to the home by the provider and surveys given to the people who live in the home on an annual basis. These make sure that the people who live in the home have the chance to say what they think about the care Care Homes for Older People Page 20 of 26 Evidence: they get and how the home is run. The manager holds regular staff meetings and the most recent ones at the time of our visit had been held in April 2009. She finds it better to split the meetings into individual groups so that the senior care assistants, care assistants, night care assistants, domestic assistants and cooks have the opportunity to discuss their own area of work. Resident meetings are held each month with the most recent one before our visit being held in April 2009. Issues discussed include people who live in the home, staffing, activities and general issues. Visits by the provider are undertaken each month and these cover the maintenance of the home, staff, residents and general issues. Copies of the reports of these visit are available in the home and show that the provider also knows what is happening in the home. Surveys of peoples views about the home are completed annually and the most recent one before our visit was carried out in 2008. Comments from these surveys included, the home is well run and staff are excellent, everyone is kind and efficient, the staff are always available, the meals are very good and I am happy here. It is recommended that the analysis of this information is shared with other interested parties including the commission. A range of policies and procedures was available within the home and these had been reviewed by the manager in February 2009. It is recommended that all policies, procedures and other documentation are checked to ensure that the address and name of Care Quality Commission is correct so that people have access to up to date information. The manager told us that she keeps some money on behalf of the people who live at Park Mount. A record system is in place and a sample of balances was checked and found to be correct. It was recommended that a financial sheet be drawn up for each person who lives at the home and that monies be checked by the manager regularly as good audit practice to ensure that the money held for people who live in the home is correct. Day to day supervision of staff was good and regular formal supervision is undertaken on with records kept. This helps to make sure that staff receive guidance and are able to discuss their care practice with the manager. Care Homes for Older People Page 21 of 26 Evidence: Safe working practices were in place within the home. There were up to date safety checks on the electrical wiring and gas installation. However from the gas check earlier in 2009, a certificate had not been issued and we asked that this be obtained to show that the gas installation is checked and safe. There were policies within the home with regard to safe working practices which included health and safety, accident and first aid, infection control, manual handling, fire and food safety. We also saw the fire safety equipment tests log book. This showed that up to date checks had been made of the fire safety system and staff had received regular fire awareness training. The accident records were seen and it was noted that these were not produced or stored in line with the Data Protection Act. We recommended that action be taken to provide the new accident books which comply with this legislation. Care Homes for Older People Page 22 of 26 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 23 of 26 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 The residents guide should be developed to include pictures and the review date and produced in other formats such as large print and audio versions to make it easy for people to understand. The document used to gather information about peoples needs before they move into the home should be signed and dated by the person doing the checks to make it clear who did the assessment and when. Photographs of people who live in the home should be included in their care records so that people know who they are reading about and if a person goes missing an accurate photo of them is available. The individual parts of soft diet meals should be blended separately so that the person may choose which parts of the meal they put together or not. All policies, procedures and other documentation should be checked to ensure that the address and name of Care Quality Commission is correct so that people have access to up to date information. The analysis of the survey information should be shared with other interested parties including the Commission, so Page 24 of 26 2 3 3 7 4 15 5 33 6 33 Care Homes for Older People that the views of the people who live in the home are made known to others who are interested in the service. 7 35 A financial sheet should be developed for each person and their monies should be checked by the manager on a regular basis as good audit practice to ensure that the money held for people who live in the home is correct. Accident records should comply with the Data Protection Act and this should include recording and storage of this information. A gas installation certificate should be obtained following the check made earlier in 2009 so that proof is available that adequate gas checks had been completed and that people who live in the home were protected by safe working practices. 8 38 9 38 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!