Care Home: Park Way

What the care home does well AQAA information stated `the home works upon a person centred approach where the service user is actively encouraged to choose their pathways of care` and `An open and honest approach to all aspects of the running of the home is encouraged, allowing all involved to feel that concerns can be openly discussed an appropriate actions taken. The AQAA also stated that `We practise person centred care where the individual is the central focus and any areas of diversity which impact upon them are addressed`. During the visit this information was found to be the case. Residents said that they liked living at the home and the atmosphere there was friendly and relaxed. One resident commented that `it is home`. Good interaction was observed between staff and residents and between the residents themselves. Residents said that they felt able to talk with the registered manager or a staff member if they had any concerns or were unhappy. No one is admitted to the home without a very detailed care needs assessment to ensure the home can meet the needs and aspirations of the person. Residents are involved in their care planning and are supported by staff to achieve their goals. A care manager had commented in their survey questionnaire that the home has `unique care plans for the unique needs of different residents`. The residents are supported to participate in a wide range of activities both in the home and the local community including working part time in shops, going shopping and developing independent living skills such as cooking and keeping their accommodation clean. Staff had received training in dealing with medication and they supported residents where appropriate to be responsible for their own medication. Residents` health care needs were being met with advice being sought from health professionals such as community mental health care team as necessary. The health professional who completed a survey questionnaire said that there was good communication between the home and health care staff. Residents are involved in decision making for all aspects of life at the home including the recruitment of new staff, menus and the redecoration of the home. What has improved since the last inspection? Care plans have been improved to provide clear guidance for staff to minimise the risks with identified mental health needs such as going out alone. In the plans seen advice had been sought from community mental health services to ensure all identified risks were recorded and staff made aware of the actions needed to minimise the risks while allowing the resident to be as independent as possible. Clear records are kept of the diet residents are receiving and the records are monitored to ensure a nutritious diet is taken. Changes have been made to the method for providing meals for the residents with only one resident now responsible for their main meal and the other residents being provided with their main meal by catering staff. Although no new staff have been employed since the last inspection, recruitment process were taking place for one applicant to start work at the home. Confirmation was on file that all necessary checks including Protection of Vulnerable Adult (POVA) and Criminal Records Bureau (CRB) were completed prior to the new staff member being given a start date to work at the home to minimise the risks to the health and safety of the residents and ensure new staff are suitable to work at the home. The carpet has been replaced in the first floor bedroom where a damaged carpet was identified as a safety hazard at the last inspection. All residents have been provided with a lockable drawer for storing personal items and residents have a key to their own room so that they can lock it as they wish. One resident had declined the offer of a key for their room and this was recorded in their file but the key was available should they change their mind at a later date. CARE HOME ADULTS 18-65 Park Way 76 Alexandra Road Farnborough Hampshire GU14 6DD Lead Inspector Marilyn Lewis Unannounced Inspection 24th April 2008 10:00 Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park Way Address 76 Alexandra Road Farnborough Hampshire GU14 6DD 01252 547782 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) Mr Lawrence Alexander Mrs Diane Alexander Miss Lisa Carolyn Mitchell Care Home 13 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (13) of places Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users are not to be admitted under the age of 18 years Date of last inspection 3rd May 2007 Brief Description of the Service: Park Way provides care for up to thirteen male and female adults, aged 18 to 65 years, within the mental disorder category. Mr and Mrs Alexander own the home and Miss Lisa Mitchell is the registered manager. Mr And Mrs Alexander own the Park Group of services that consist of Park View, Park Way and Park Avenue homes and an Outreach service. The home is located in Farnborough within easy access to local shops and other amenities. The home is on a main bus route. The building is a three-storey domestic detached house, comprising of seven single and three double bedrooms. One of the single rooms provides an independent flat facility on the second floor. The homes communal space comprises of two lounges and separate dining room, a small conservatory and a further conservatory that provides a smoking facility. There is a garden, which includes seating for residents and visitors. The home’s fees range from £425 to £600 per week depending on need and the room provided. Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Information received in the form of the Annual Quality Assurance Assessment (AQAA) completed by the registered manager and completed survey questionnaires from nine residents, six staff members, a health professional and two care managers and the information obtained during a visit to the home was taken into account when writing this report. The unannounced visit to the home took place on the 24th April 2008. The inspector met with the registered manager, the registered provider, staff members and residents. Care plans were seen and also records including those for staff training, complaints and medication. A resident showed the inspector around the home. During the visit the people living in the home said that they wished to be known as residents and so they are referred to as residents in the report. What the service does well: AQAA information stated ‘the home works upon a person centred approach where the service user is actively encouraged to choose their pathways of care’ and ‘An open and honest approach to all aspects of the running of the home is encouraged, allowing all involved to feel that concerns can be openly discussed an appropriate actions taken. The AQAA also stated that ‘We practise person centred care where the individual is the central focus and any areas of diversity which impact upon them are addressed’. During the visit this information was found to be the case. Residents said that they liked living at the home and the atmosphere there was friendly and relaxed. One resident commented that ‘it is home’. Good interaction was observed between staff and residents and between the residents themselves. Residents said that they felt able to talk with the registered manager or a staff member if they had any concerns or were unhappy. No one is admitted to the home without a very detailed care needs assessment to ensure the home can meet the needs and aspirations of the person. Residents are involved in their care planning and are supported by staff to achieve their goals. A care manager had commented in their survey questionnaire that the home has ‘unique care plans for the unique needs of different residents’. Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 6 The residents are supported to participate in a wide range of activities both in the home and the local community including working part time in shops, going shopping and developing independent living skills such as cooking and keeping their accommodation clean. Staff had received training in dealing with medication and they supported residents where appropriate to be responsible for their own medication. Residents’ health care needs were being met with advice being sought from health professionals such as community mental health care team as necessary. The health professional who completed a survey questionnaire said that there was good communication between the home and health care staff. Residents are involved in decision making for all aspects of life at the home including the recruitment of new staff, menus and the redecoration of the home. What has improved since the last inspection? Care plans have been improved to provide clear guidance for staff to minimise the risks with identified mental health needs such as going out alone. In the plans seen advice had been sought from community mental health services to ensure all identified risks were recorded and staff made aware of the actions needed to minimise the risks while allowing the resident to be as independent as possible. Clear records are kept of the diet residents are receiving and the records are monitored to ensure a nutritious diet is taken. Changes have been made to the method for providing meals for the residents with only one resident now responsible for their main meal and the other residents being provided with their main meal by catering staff. Although no new staff have been employed since the last inspection, recruitment process were taking place for one applicant to start work at the home. Confirmation was on file that all necessary checks including Protection of Vulnerable Adult (POVA) and Criminal Records Bureau (CRB) were completed prior to the new staff member being given a start date to work at the home to minimise the risks to the health and safety of the residents and ensure new staff are suitable to work at the home. The carpet has been replaced in the first floor bedroom where a damaged carpet was identified as a safety hazard at the last inspection. All residents have been provided with a lockable drawer for storing personal items and residents have a key to their own room so that they can lock it as they wish. One resident had declined the offer of a key for their room and this was recorded in their file but the key was available should they change their mind at a later date. Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A detailed care needs assessment is completed for all potential residents before a place is offered to ensure the home can meet the person’s needs. People are provided with enough information about life at the home and can visit as many times as they wish before making a decision about taking a place there. EVIDENCE: The home is in the process of reviewing its Statement of Purpose and Service User Guide to provide clearer information for potential residents. The current format does not clearly indicate that Lisa Mitchell is the registered manager of the home and this is one of the areas being addressed. A resident who had recently moved into the home said in the survey questionnaire, he had been asked to complete by the home to obtain his views on the admission process, that he had received enough information about the home and that he had been able to visit on numerous occasions before making the decision to live there. The registered manager said that a full needs assessment was completed for all potential residents prior to offering a place at the home to ensure the home can meet their care needs and will be able to support them to become more independent. Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 10 The records seen for the new resident confirmed that the assessment was very detailed and covered all aspects of care needs including support for life skills such as making a cup of tea or doing laundry and ironing, financial skills and social skills such as conversing with others and using public transport. Risk assessments are included in the needs assessment. Reports from a care manager and health professionals were included in the completed assessment report. Each resident had been provided with a written contract giving the terms and conditions for living at the home. The contract seen did not clearly inform the resident how a complaint could be made. There was however a clear complaints procedure on display on the notice board in the hallway. The registered provider said that she would update the complaints procedures in the contracts. Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are involved in their care planning and are supported to take risks as part of an independent lifestyle. Residents make decisions about their own lives and in all aspects of life in the home. EVIDENCE: AQAA information stated that residents were supported to write their own care plans if they wished and a resident spoken with during the visit confirmed this. The resident said that their key worker discussed their wishes with them and then they were written in the care plans. Three other residents asked, said that they knew what was written in their care plans and agreed with them. Care plans seen documented the residents’ goals such as being able to go out and locate the local shops, bank and learn where the buses stopped and which number bus to take for various destinations. The support required to enable the resident to meet the goals had been documented and the care plans had Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 12 been reviewed showing that the goals had been achieved. A new goal had then been documented and this was being worked towards. At the last inspection a requirement had been made for care plans to set out procedures and guidelines for staff to follow to minimise the risks identified with mental health issues. Care plans seen at this visit contained the risk assessments, which included triggers for behaviour changes, actions to be taken by staff to minimise the risks of challenging behaviour and also the actions to be taken if challenging behaviour was exhibited. A staff member said that the care plans now provided very clear information and were easy to follow. Residents said in their surveys that they were able to make decisions about their own lives and life at the home. This was evident during the visit when residents and staff were observed chatting in a friendly manner and staff were seen to support the residents in making decisions such as what they would like to do during the day or what they would like to buy when out at the shops. The atmosphere was very relaxed and one resident said that it ‘was home’. The registered manager said that meetings were held regularly for residents to discuss the way the home was run, including the admission of new residents and the menus and residents confirmed this. Residents also said that they had been involved in the interviewing of new staff members. Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are able to receive visitors and participate in a variety of social activities both in the home and the community as they wish. Staff support the residents to achieve their goals regarding obtaining work or attending classes to improve their daily living skills. The residents enjoy the choice of nutritious meals provided. EVIDENCE: Three residents spoken with said that they were able to decide for themselves what they wanted to do, such as spending time in their rooms, going out to the shops and contacting relatives. The residents’ wishes were documented in their care plans and those plans seen indicated that staff supported the residents to achieve their wishes. One resident had been supported to find part time work at a local charity shop, one was looking at classes to improve reading skills and another worked part time at a local pet shop. Some of the residents had joined social groups and the wishes of others not to attend groups or clubs were documented in their care plans. Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 14 One resident attends church services regularly and some go to services occasionally as they wish. Records seen indicated that the residents were involved in a variety of activities including baking, board games, walks, badminton, discos, shopping and attending art groups and social clubs. A resident said that ‘I like chatting with my friend from next door’ and another said ‘I like going out with my family’. The property next door is another care home owned by the same providers and the registered manager said that joint social activities take place such as the recent ‘St Georges Day’ event. During the visit some of the residents from the two homes met together in the garden and chatted in a friendly and relaxed manner. Risk assessments had been completed for residents who wished to go out alone. The new resident had been accompanied on trips out until staff felt he was able to manage alone. The risk assessments had then been reviewed to reflect this. Care plans seen indicated that two of the residents had become very close friends at one time. The registered manager said that their wishes were respected and they were advised to seek advice should their friendship develop into a relationship to ensure both were aware of any issues that could arise. A relationship had not developed and they remain friends. Eleven of the current twelve residents are male, with one female. The female resident said that she was very happy living at the home and did not mind being the only female resident as there was a mix of female and male staff. The resident also said that she spent a lot of time with her female friend from the home next door. Some of the residents go home for weekends or go for days out with family members and others receive visitors as they wish. The registered manager said that visitors were welcome at any reasonable time and a resident confirmed this. At the time of the last inspection residents were responsible for providing the groceries for their own main meals from money given to them by the home. It had not been possible to confirm that the residents had been receiving nourishing meals that met their dietary needs, as records were not available of the meals taken. The registered manager said that following discussions with the residents the systems had been changed and residents were provided with a choice of main meals at lunchtime to ensure they were receiving a nutritious meal. The meals were prepared by a cook in another of the homes run by the company, which is nearby and is brought to the home for reheating. Records were kept of the meals taken and also food safety issues such as the temperature of the meals served. Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 15 Residents said that they preferred this method and enjoyed the meals provided at the home. On the day of the visit lunch consisted of pork casserole, roast potatoes, swede and carrots followed by fruit and cream or yoghurt. A staff member said that an alternative meal was always available should a resident not wish the main choice and residents confirmed this. Meal portions were good and the food was well presented. Residents said that the meal was ‘very good’ and ‘I am enjoying this’. The registered manager said that one resident did not wish to have the same meals as the others but chose his meals on a daily basis from foods he liked. Residents were also able to help themselves to food for snacks such as soup or sandwiches, at other times of the day. Bowls of fruit were on the dining tables for residents to help themselves as they wished. Records seen for one resident who was a diabetic indicated that they had been encouraged by staff to take breakfast as they said they did not feel like eating in the morning. Staff had suggested different items of food that the resident might like to try in the morning and this had resulted in the resident eating breakfast, which minimised the risk of upset from the diabetes. Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to choose how they wish to be supported and their health care needs are being met. Staff support residents where appropriate to take responsibility for the administration of their own medication. EVIDENCE: The AQAA states that ‘The home uses a person centred care planning approach, which is evaluated at regular intervals’ and that residents ‘have a choice of who they wish to be their key workers’. Care plans seen indicated that a person centred approach was being used and the wishes of the residents were clearly documented and staff spoken with were aware of the actions they needed to take to support the residents. One resident said ‘I chose my key worker because I like her and she helps me to look after myself’. During the visit staff were seen to support the residents in a friendly relaxed but respectful manner that provided residents with opportunities to discuss their care in a relaxed atmosphere. Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 17 Residents said that they were able to make their own decisions about their daily lives such as when to get up and go to bed and what to wear. Care plans and records seen indicated that residents’ health care needs were being met. Visits to GPs, dentists, opticians and chiropodists were recorded and also appointments attended at hospital outpatients departments and community nurse clinics. Reports from community mental health support services and psychiatrists were also included in the records. At the time of the last inspection records monitoring the health care for residents had not all been documented which could have resulted in appointments being missed. Since then the recording of health care needs and appointments has improved and those seen were up to date. The home has clear procedures in place for dealing with medication. The registered manager said that following a risk assessment one resident is responsible for administering his own medication and another is working towards this. The resident who self medicates keeps his medication in a locked drawer in his room and staff check with him twice a day that he has been taking his medicine as prescribed. No controlled drugs were being prescribed for residents at the time of the visit but procedures were in place for their administration should this change. Systems were in place to allow residents to take medication away from the home such as during visits to family. Staff said that they had received training in dealing with medication and records seen confirmed this. Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents know that any complaints will be taken seriously and investigated promptly and they are protected by staff awareness of the need to protect vulnerable adults from abuse. EVIDENCE: Residents said in the survey forms that they would speak with the manager or their key worker if they had any problems or complaints. One resident said during the visit that ‘I would tell the manager if I was unhappy and she would sort it out’. The complaints procedures were displayed on the home’s notice board and as documented in Standard 1, the registered provider said that she would update the complaints procedures in the written contracts. AQAA information stated that one complaint had been received in the last year and this had been resolved within twenty-eight days. At the time of the last inspection recruitment records seen for a staff member indicated that the person had commenced work at the home before a Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks had been completed which could have put the safety of the residents at risk. Since then the process for recruitment of staff has improved and records seen indicate that all the necessary checks would be completed prior to a new staff member starting work. Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 19 The home has clear procedures for handling residents’ money. Records are kept of monies received and all transactions. Records seen for two residents matched the amount of money held. The money is stored securely. The staff member and the resident sign the records each time a transaction takes place and staff check the records and the amount held for each resident at the change of each shift. Staff said that they had received training in the protection of vulnerable adults and records seen confirmed this. A staff member who was asked knew the procedures to follow should abuse be suspected. The homes procedures for the protection of vulnerable adults were readily available for staff. The registered manager said in the AQAA that ‘Due to the introduction of the Mental Capacity Act we now need to be looking at the use of Independent Mental Capacity Advocates. The AQAA also states that ‘the home adopts the opinion that each service user has the capacity to make all their decisions unless proved otherwise. Workers are also aware that service users’ capacity may change daily and assess this at each individual decision’. The AQAA states that one of the areas the home has improved in the last twelve months is by ‘responding to government legislation and are training employees in the awareness and application of relevant Acts. For example; the safeguarding of adults, the Mental Capacity Act and No Smoking Policy’. Records seen confirmed training for staff was taking place. Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Parkway provides a clean and homely environment for residents and visitors. EVIDENCE: The home looked clean and homely. Accommodation comprises of a ground floor lounge, first floor lounge, dining room with an additional seating area, conservatory, kitchen, laundry room, six single rooms, three double rooms and a self contained flat. One of the single rooms and two of the double rooms have en-suite facilities. There are also two bathrooms and two shower rooms. There is also a sleep in room for staff and an office. Residents said that they really liked their rooms and one of the residents accompanied the inspector on a tour of the home. Residents’ rooms had been personalised with items such as posters, pictures and personal audio equipment so that each was different. At the time of the last inspection the carpet in one of the residents’ rooms was damaged and this has been replaced with a new carpet. Lockable storage Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 21 space was also needed and this has been provided in the form of a lockable drawer for each resident. Residents have all been provided with a key to their room so that they can lock the door if they wish. I resident had declined to have a key and this has been recorded in his file. Residents said that they helped to keep the home clean and rotas for tasks were in their care plans. The home looked clean and staff said they had received training in infection control and records seen confirmed this. The registered manager said that there was an ongoing programme of redecoration and refurbishment and the home looked generally well maintained. Since the last inspection a new entertainment system and seating has been purchased for the main lounge, new seating provided for the conservatory and three new beds have been purchased. The dining room, conservatory, ground and first floor corridors and a bedroom have all been redecorated. AQAA information states that further improvements are scheduled in the next twelve months including updating the kitchen, providing en-suite facilities in some bedrooms and the provision of a games/activities room for use by all residents. Seating has been provided to the rear of the property and during the visit residents spent time sitting outside chatting. Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Robust recruitment procedures are used when employing new staff to minimise the risks to the safety of the residents. Staff receive the training and supervision needed to fully support the residents. EVIDENCE: The home employs the registered manager, a senior support worker and seven support workers. A resident said that enough staff were on duty for each shift and a staff member agreed. All staff members except one hold a National Vocational Qualification (NVQ) in care, to level 2 or above. The one staff member who does not hold the qualification is due to commence the training for this in September 2008. Staff said that they had received training in first aid, health and safety, food hygiene, safe handling of medication, risk assessing and the protection of vulnerable adults. Records seen confirmed training had taken place. Staff also received training in specific topics relevant to the provision of care for the residents including challenging behaviour and community mental health. One staff member commented that the training programme was very good. Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 23 At the time of the last inspection recruitment records seen indicated that a staff member had started work at the home prior to the completion of Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks, which could have put the safety of the residents at risk. No new staff members have been employed since then but the registered manager was in the process of recruiting two new staff members and the records seen indicated that all the necessary checks including a POVA were being obtained before the person was given a start date. Applicants are asked to visit the home to meet residents and to provide an opportunity for residents to be involved in the interview process. One resident confirmed that they had assisted in the interview of a new staff member and they said that they enjoyed it. Two staff members said that they received supervision from the registered manager and staff records seen confirmed that staff are receiving regular supervision. Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run in the best interests of the residents. EVIDENCE: The registered manager, Miss Lisa Mitchell, has obtained the registered managers award and other relevant qualifications such as Train the Trainer. Miss Mitchell has been employed at the home for ten years, initially as a key worker, then a senior support worker and as manager for the last five years Residents said that they could ‘talk’ with the manager and a staff member said that she received very good support from the registered manager. During the visit it was evident that Miss Mitchell had a good rapport with both the residents and staff. Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 25 Two of the residents said that they enjoyed meetings where they discussed life at the home as a group. The registered manager said that during the meetings some of the residents had said that they wished to go on holiday and discussions had taken place about where and when they would go. As a result some residents are going to the New Forest at the end of May and some to a holiday camp in September. The registered manager said that she is looking into restarting a relatives group. Miss Mitchell said that a group had been run in the past where relatives got together for chats and support but this had stopped and the current relatives might wish to start the group again. Miss Mitchell also said that relatives were invited to social events like BBQs and there were opportunities for them to talk with the registered manager or other staff members at these events or during visits to the home where the registered manager operates an open door approach. The registered provider visits the home at least once a month to monitor the quality of the care provided. Questionnaires regarding the welcome and admission process for new residents were provided for people shortly after they moved into the home to gain their views on the process. A completed questionnaire was seen in a new residents records as documented in Standard 1 of the report. A staff member said that they found the monthly staff meetings helpful. The registered manager said that the minutes of the meetings were provided for each staff member so that those unable to attend were kept up to date. Minutes of the last staff meeting and the residents meeting were displayed in the office. Service certificates and records showed that fire safety equipment was being serviced and tested as needed and staff were receiving fire safety training and attending fire drills. The registered manager said that she was in the process of completing a fire safety assessment for the building. Records seen confirmed staff received training in health and safety issues including food hygiene and infection control. Risk assessments for the use of hot water and from uncovered radiators have been completed since the last inspection showing the levels of risk to be low. At the time of the visit the temperature of the hot water from the bath taps could not be checked, as the thermometer could not be found. Following the visit the registered manager notified the inspector that a new thermometer had been purchased and the water temperature had been checked and was at the required level. The registered manager said that she would ensure the temperature of the water was monitored and recorded. Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No Score 22 23 3 3 X 3 3 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000012057.V361003.R01.S.doc LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Park Way Score 3 3 3 X 3 3 3 X X 3 X Version 5.2 Page 27 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Park Way DS0000012057.V361003.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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