Care Home: Park View

What the care home does well The home provides care in a well-maintained pleasant environment by a stable wellmanaged supported, motivated, well-trained and qualified staff team who work in a manner that recognises resident`s need for personal privacy and dignity. The home continues to offer a level of service that meets residents needs and expectations. What has improved since the last inspection? The previous requirement relating to the recording of medication administered has been complied with. A new kitchen has been provided and NVQ training made available to all staff. What the care home could do better: Following this inspection no recommendations or requirements were made and there were no areas of concern. Daily menus should be available in a format that all residents can understand. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Park View 7-10 Church Circle Farnborough Hampshire GU14 6QH     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: Peter McNeillie     Date: 0 6 0 4 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 View 7-10 Church Circle Farnborough Hampshire GU14 6QH 01252547882 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Lawrence Alexander,Mrs Diane Alexander care home 32 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 32 The registered person may provide the following category of service only: Car home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Dementia (DE) Mental disorder, excluding learning disability or dementia (MD) Date of last inspection Brief description of the care home Park View is a care home registered to provide accomodation care and support for up to thirty two residents over the age of 65 some of whom may have dementia or mental health care needs. The home may also admit male and female residents from the age of 55 years with mental health care type needs. Care Homes for Older People Page 4 of 26 Over 65 0 0 32 32 Brief description of the care home The home which is located in a quiet residential part of Farnborough is part of the Park Group who are responsible for other sevices in the area and the South of England. Local shops and community facilities, public transport are all nearas is access to the M3 motorway . The home consists of two separate, sixteen bedded, three-storey houses linked by a secure garden and patio area. Accomodation is available in single and large double rooms. On site off road parking is available. Care Homes for Older People Page 5 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: This report was written after taking into consideration a number of sources of information and evidence. These included site visits to the premises, previous reports, sampling residents, staff training and recruitment records, talking with residents, staff and management and a response by the manager to a pre inspection Annual Quality Assurance Assessment. (AQAA). During this inspection which took place on 24/02/09 between the hours of 9.00 am and 1.00 pm and 06/04/09 between the hours of 9.00 am 11.00am all of the key standards for older persons were inspected. The results and findings contained in this report will determine the frequency and type of future inspections. At the time of our visit charges varied between three hundred and thirty pounds and six hundred and thirty pounds per week. Care Homes for Older People Page 6 of 26 What the care home does well: 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 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 7 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 8 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. The home has a system of assessing and identifying residents needs which ensures residents safety and their assessed needs can be met. Intermediate care is not provided so this standard does not apply. Evidence: The manager informed us that residents were only admitted in accordance with the homes pre admission policy and procedure that requires a detailed written assessment of needs and risks being carried out by a member of the homes management team in consultation with the prospective resident or their representative. A Sample of four residents pre admission assessments chosen at random were viewed. All were produced in accordance with the policy and procedure previously referred to Care Homes for Older People Page 9 of 26 Evidence: and took into consideration residents care, nutritional and communication needs, wishes, choices, aspirations as well as any attendant risks and confirmed that potential residents are consulted about and were involved in the assessment process. Where the resident is funded by a local authorities social services department this would also include an assessment by a care manager. As part of the admission process management also liaise with external health and social care professionals regarding any care needs, risks, equipment and aids, that need to be considered and included when developing a plan of care. Records also confirmed ongoing assessments of need and risk for all residents are carried out on a regular basis and care plans (Section 7-11 of this report refers) updated to reflect any changes. Intermediate care is not available in the home. Care Homes for Older People Page 10 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 home has a well-developed system of planning and reviewing care, which reflects residents, wishes, and aspirations and ensures residents needs are met within a risk management policy that involves residents or their representatives in decisions that affect them. Evidence: Residents right, and the opportunity to take risks are seen as fundamental. Residents were supported to make decisions for themselves within a risk assessment framework with the help of staff if required. This process identified individual risks and how they were to be managed. Staff who had a good understanding of the contents of the care plans and risk assessments were able to explain how the care plan was put into day-to-day practice. Residents were able to see or consult with any health and social care professional of their choice when they needed to. Records were kept of appointments with GPs, dentist, optician, chiropodist and any other external health and social care professional Care Homes for Older People Page 11 of 26 Evidence: and included details of any advice and treatment given. Records also confirmed apart from doctors, district nurses other specialists would be consulted as required. Currently Doctors and nurses from three local practices visit the home. Resident also confirmed that their individual privacy was respected and that staff always knock on their bedroom door and wait before entering, a practice we observed during this visit. Following the last inspection a requirememnt was made that You must ensure that accurate records of the administration of medication to people are maintained at all times. All medication which is dispensed by a pharmacist into a nomad system stored and administered in accordance with a medication policy and procedure by staff all of whom have received training in the administration, recording and the security required when handling residents drugs and medication. The procedure also includes provision for these residents who wish subject to a risk assessment to retain responsibility for their own medication. At the time of our visit, following a risk assessment no resident was responsible for his or her own medication. We viewed a sample of records covering medication administered to resident sand found them to be complete and accurate. In the light of our findings we are satisfied the previous requirement had been complied with. In response to our questions relation to equality and diversity, in there AQAA, we were told that the home: Practise person centred care where the individual is the central focus and any areas of diversity which impact upon them are addressedThe community has a range of different religious places of worship or an appropriate member of the religion would be welcomed into the homeWe pride ourselves on having a mixed workforce from various backgroundsPolicies and procedures are continually adopted and adapted within the care homeAgeist attitudes within the home or professionals entering the home would not be tolerated by either staff working within the home or professionals entering the homeCare of dying policies and procedures properly take into account both the wishes of the patient and any religious observations of his/her religionContinue to work with all employees and take on board their comments regarding their workplaceContinue Annual review of policies and proceduresMaintain our Equal Opportunities monitoring Care Homes for Older People Page 12 of 26 Evidence: system which compares our ethnic composition with local demographic area. We are maintaining our protocol of changing working practices to meet the equality and diversity needs of new patients as identified during the pre-admission assessmentWe continue to promote mental health in a positive lightWe have revamped our Pre- admission documentation to address dietary needs to ensure the home complies with any religious or personal beliefs.We have compiled a list of leaders/places of various faiths; local minority groups which relate to equality and diversity issues; and other access agencies within the area. 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. Activities, access to the community, family contacts, mealtimes and the provision of varied and nutritious meals were very well managed and reflected residents interests and choices. Evidence: To ensure a wide range of activities is available a senior member of the care staff team has a lead role to organise activities, which reflect residents, needs and wishes. A notice in a dual written and pictorial format showing activities many of which takes place in a separate activities room was displayed.This room can also be used for private meetings These included, in house games, exercise, walks, shopping trips, trips to shows, pantomimes etc and trips out on a one to one basis. Residents told us they were happy with the activities available and confirmed there was always something they could take part I if they wished. Residents told us that residents are free and encouraged to make decisions about their Care Homes for Older People Page 14 of 26 Evidence: day to day lives such as, mealtimes, where meals are taken, visiting times, the right to receive and converse with visitors and to make and receive telephone calls in private. The quality, quantity, presentation and choice of food served came in for particular praise from the residents. A written daily menu based on residents likes and dislikes and a choice of meals was displayed. The manager acknowledged the need to ensure that the menu was displayed in format that all residents would understand and that this is of prime importance for persons with dementia who may find the addition of pictures would be beneficial to understanding what they are eating. A verbal undertaking was given by the manager to extend the use of pictures to the daily menu. We observed residents taking their mid day meal. This was conducted in a relaxed unhurried manner. Tea and coffee were available to residents and visitors at all times as was water and fruit squash. We observed staff encouraging residents to drink fluids to ensure they did not become de hydrated. 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 home has clear policies and procedures in place that ensures residents are protected from abuse. The complaints procedure was satisfactory with evidence that residents feel their views will be acted upon. Evidence: A record of complaints and the homes complaints procedure was which was also included in the service users guide included information on how to contact The Commission for Social Care Inspection (CSCI) was available. Residents and staff spoken with confirmed they were aware of the complaints procedure and stated they felt comfortable in discussing any concerns they had with the homes management and confident any matters raised would be dealt with fairly and promptly. An Adult Protection policy and procedure designed to safeguard residents from abuse, which worked in tandem with the multi agency policy, and procedure produced by Hampshire County Council as the lead agency for the safeguarding residents was available. Management and staff spoken with and records viewed confirmed they had received Care Homes for Older People Page 16 of 26 Evidence: training in recognising abuse and demonstrated they knew the outside lead agency responsible for the safeguarding of residents and the procedure to follow should they witness or suspect the abuse of any resident. Care Homes for Older People Page 17 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. A safe, well maintained, clean, suitably furnished home is provided for residents, which meets their needs. Evidence: The homewhich comprises two large houses linked by a secure garden and patio area is located in a quiet residential area of Farnboroug close to local shops, public transport. and other communal ammentiies. The town of Farnborough is within easy travelling distance of Camberley,Fleet, Aldershot, Guilford, Basingstoke and Winchester all of which can be accessed via major trunk roads or motorway. All areas of the home were clean and free from unpleasant odours and obvious hazards. Residents confirmed to us in the home is always clean and smells fresh. Furniture was comfortable, homely and in a good state of repair and met residents individual and collective needs. Apart from personal mobility aids a number of communal aids had also been provided to assist residents to access all of the communal areas including the well-tended, large established and safe garden. Care Homes for Older People Page 18 of 26 Evidence: These included special baths hoists; grab rails, toilets, chairs etc all of which had been taken into consideration at the initial pre admission assessment as describe in sections 1 to 6 of this report. Since our last visit a new kitchen had been installed and other areas redecorated or refurbished in accordance with a rolling programme of maintenance and refurbishment that ensures the building is well maintained, decorated and safe. Care Homes for Older People Page 19 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. Residents needs are met by sufficient numbers of trained staff who are recruited and selected using a procedure designed to protect all residents. Evidence: In our view, with which the residents agreed, at the time of our visits staff numbers and the deployment of staff was sufficient to meet their needs. The planned staffing level for the home is 7.30am to 2.30pm four care staff plus The manager, two cleaners and one person in the laundry (for part of the shift), 2pm to 9pm four care staff plus The manager, two cleaners and one person in the laundry (for part of the shift), 8.45pm 7.45am two waking staff, plus one sleeping plus telephone back up for emergencies. We were also informed us staffing could would be raised if residents needs increased. As part of this inspection, we viewed four staff recruitment and training files selected at random. All files viewed included evidence that staff are employed in accordance with a robust equal opportunities recruitment, and selection procedure, which is designed to protect residents. Care Homes for Older People Page 20 of 26 Evidence: This involves the completion of an application form, the signing of a rehabilitation of offenders declaration, an interview, and satisfactory Criminal Record Bureau (CRB) disclosure, Protection of Vulnerable Adults (POVA) and reference checks. Following their appointment, records seen confirmed that all staff are subject to an in house induction and a training programme that include first aid, handling medication, food handling, moving and handling, safeguarding and infection control as well as other training required to equip them to do their job. Details of all staff training is held on a comprehensive planning matrix that also includes dates for training to be updated covering a twelve month period. Following completion of their induction programme All staff are expected to undertake a National Vocational Qualification N .V. Q.) Course. Information provided indicated that 62.5 of staff has been trained to at least NVQ level 2, 18.75 to NVQ level 3 with a further 18.75 due to start a course as soon as possible. Care Homes for Older People Page 21 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 management of the home ensures the health, safety and welfare of residents and staff are promoted and the home is run in the best interests of the residents, whose views about living in the home are formally sought. Evidence: From all of the information we received and our observations we concluded that the home is well managed by a manager who has worked in the home for a number of years. Apart from her experience, she holds an NVQ registered managers award at level four, an NVQ in care level three (currently involved in a NVQ four course) and is an NVQ assessor. Residents spoken with were full of praise for the manager and the way in which the home is managed they also confirmed they can speak to the manager and all care staff at any time and they are always willing to listen and give them time. In talking with the manager and staff it was evident that clearly defined management Care Homes for Older People Page 22 of 26 Evidence: structure was in place. All of the staff spoken with staff was aware all of their responsibilities and the limits of their authority. Staff informed us the homes management were supportive, approachable and accessible and willing to listen to any ideas they may have for the improvement of the service. As part of the homes quality monitoring system, residents, residents representatives, staff and visiting health and social care professionals are invited to participate in satisfaction surveys. The views expressed in these surveys are seen as key in highlighting areas that may require improvement or attention for the future development of this service. An in house health and safety policy was in place to ensure the day-to-day safety of staff and residents. Procedures include, health and safety checks, the regular servicing of equipment, staff training in the techniques of moving and handling infection control, control, first aid, health and safety, procedures to follow in the event of fire (including evacuation), in addition all staff are issued with protective gloves and aprons and have access to antiseptic hand gel and soap. We were informed that all of the hot water supplies to baths were fitted with thermostatic controls set at 43 degrees centigrade and all radiators and hot pipes were covered to prevent a resident or staff being burnt. . Care Homes for Older People Page 23 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 24 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 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!