Care Home: Parkfields

What the care home does well People are cared for by staff who have a good understanding of the needs of the people accommodated. The staff team is culturally diverse, some staff speak a variety of languages, which helps in the communication with people from different ethnic backgrounds. People told us that they like living at the home and that the staff are kind and helpful. People are pleased with the care they receive and their care plans provide staff with the information they need to meet individual needs. The home provides meals that offer variety and cater for different cultural and nutritional needs. What has improved since the last inspection? The home has improved care planning processes and now provides clear guidance on wound care for people who have wounds. At this inspection it is seen that the home has improved its recruitment procedure. Bed rails which were seen were fitted correctly and a new maintenance person has been appointed. The home has continued with its re-furbishment programme to improve the living accomodation. What the care home could do better: No requirements are made as a result of this inspection. Some improvements are needed to management systems and processes such as the recording of complaints, quality assurance processes and recording of training. These improvements were discussed with the manager who provided us with reassurances that these improvements would be made. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Parkfields 556 Wolverhampton Road East Parkfields Wolverhampton West Midlands WV4 6AA     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: Rosalind Dennis     Date: 2 1 1 0 2 0 0 8 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. the things that people have said are important to them: They reflect 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 © (2008) 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Parkfields 556 Wolverhampton Road East Parkfields Wolverhampton West Midlands WV4 6AA 01902621721 01902339915 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Cheryl Fenton Type of registration: Number of places registered: Dr Uma Passi,Dr Mohan Lal Passi care home 49 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability terminally ill Additional conditions: No number division between categories except 3 (only) palliative care. Up to a maximum of 7 beds may be used for intermediate care. Date of last inspection Brief description of the care home Parkfields Nursing Home is a privately owned care home registered with the Commission for Social Care Inspection to provide nursing care to 49 people. The home also provides respite care and admits people on a step down basis from hospital. Parkfields Nursing Home is owned by Dr Mohan Lal Passi and Dr Uma Passi. Ms Cheryl Fenton is the registered manager and has day to day management responsibility for the home. Parkfields Nursing Home is a two-storey, purpose built accommodation set in attractive grounds with parking at the front and gardens to the side and rear. Twenty-two bedrooms have en-suite facilities, all other bedrooms have a hand-wash Care Homes for Older People Page 4 of 26 Over 65 49 0 49 3 Brief description of the care home basin. The communal areas comprise of 3 lounges and a separate dining area. A lift provides access between floors and the building has a number of level access points to the garden. The Home is situated close to Wolverhampton city centre, on a public transport route and with shops and local services nearby. At the time of this inspection the manager reports that the current weekly fee ranges from 348 -454 pounds, depending on the needs of the individual and whether people need nursing care. The reader may wish to obtain more up to date information from the care service. People can obtain information about this service from the homes Statement of Purpose and Service User Guide. Inspection reports produced by CSCI can be obtained direct from the provider or are available on CSCIs website at www.csci.org.uk. The last key inspection of this service was 25th October 2007. 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: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was unannounced and was conducted by one inspector over a period of around 7 hours. All key standards were assessed during the day-that is those areas of service delivery that are considered essential to the running of a care home. During the inspection we spoke with people living at the home, visitors, staff and the manager, Cheryl Fenton who was on duty for the duration of the inspection. Time was spent observing and finding out how people spend their days and looking at the interactions between staff and people living at the home. We also looked at care records and other documentation and observed a selection of bedrooms and communal areas. Care Homes for Older People Page 6 of 26 Prior to this inspection an Annual Quality Assurance Assessment (AQAA) document was sent to the manager for completion. The AQAA is a self-assessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for providers to share with us areas that they believe they are doing well. It is a legal requirement that the AQAA is completed-Parkfields Nursing Home returned their completed AQAA to us within the given timescale. Information provided within the AQAA has been used to supplement the inspection process. We also sent surveys to the home and we received nine surveys completed by people living at Parkfields Nursing Home and these responses were generally positive. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.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. The home has a good assessment and admission procedure, which means that people can be reassured that their needs will be met. Evidence: We looked at three peoples care files, which show that the manager or deputy manager assess peoples needs before they are admitted to the home. For people admitted to Parkfields Nursing Home direct from hospital then the admission process involves information being sent direct to the home from hospital, which then enables the home to determine how it will be able to meet that persons needs and plan care accordingly. One person described how they had come to the home from hospital to recover from a fall and they spoke of their satisfaction with the admission process and how they have enjoyed their stay at the home. One person commented in their completed survey to us I am very happy to be here, I could not praise them more. Care Homes for Older People Page 10 of 26 Evidence: Two people commented on their lack of involvement in decision-making as to where they were going from hospital-these comments were directed specifically to the hospital and not to the home. The home has improved the Service User Guide, which is now a comprehensive document, providing people with information on all aspects of the service and copies of the guide were seen throughout the home, including peoples rooms. Some amendments are needed to the guide in respect of fee information and we had reassurances that this would be carried out. The manager is aware of where to access translation services should people request the guide in different formats. The home continues to provide care to people on a step down basis, which is generally for individuals transferred from hospital who are waiting for a care package to be arranged before returning to their own home or sheltered accommodation. 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. Care plans and risk assessments are well written and provide staff with information to meet peoples needs. People who are able to comment on the service are pleased with the care they receive. Evidence: We spoke with people living at the home, their visitors and observed staff interactions and looked at peoples care records. People who were able to communicate their views, provided positive comments about how they are looked after, confirming that their needs are met and described staff as helpful and good. People who were less able to speak with us looked well-cared for and we saw staff undertaking regular checks to see if they were comfortable. Staff were heard communicating with people whose first language is not English, staff translated for us and people provided positive feedback about their care. One person commented within their survey staff treat me well, with great kindness and respect and during the inspection we observed staff showing kindness in their approaches with people. The care files we looked at contained a range of well-written care plans and risk assessments, providing clear guidance to staff Care Homes for Older People Page 12 of 26 Evidence: on how to safely meet individual needs. We looked at the care files for two people who have wounds, the records were detailed and included information on how to care and monitor the wounds. We looked at the care record for a person who was admitted to the home following a fall and had sustained an injury-their care records were detailed and a discussion with the person confirmed that the care which is documented is carried out. We observed staff using moving and handling equipment appropriately and promoting peoples independence. Records to show the frequency and amount of diet and fluids were up to date and people were seen throughout the inspection with drinks nearby and staff assisting when necessary. Examination of a selection of medication administration record sheets found these to be completed accurately, with all medication signed and accounted for. We observed where medication is stored and records show that medication is stored at the correct temperature. A staff member was observed following good practice whilst administering medication to people, and ensured people were offered pain relief and assistance with their medication. 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 choose to participate in social activity and the home provides meals that offer variety and cater for different cultural and nutritional needs. Evidence: People spoke of different activities, which take place at the home, such as exercise to music, Bingo and crafts and they viewed there is enough going on. Some people spoke of how they prefer their own company, preferring to read books and spend time in their bedroom rather than join in with group activities. The surveys we received reflect peoples different preferences and views on activities-two people responded always, two people responded usually and two people responded never to a question about whether there are activities which they can take part in. The home maintains records of activities, which show that besides regular activities provided by an outside entertainer who visits three times per week, the home also has musical entertainment. Some people choose to attend church and a local day centre. During the inspection we heard staff asking people what they would like for their lunch and tea, offering people a range of meals. All people spoken with during the inspection confirmed that meals provided by the Care Homes for Older People Page 14 of 26 Evidence: home are good, with choices available to meet individual preferences. 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 ensures that people have access to a clear complaints procedure and staff are provided with training to equip them with the knowledge and skills to safeguard adults from the risk of abuse or neglect. Evidence: All people spoken with during the inspection confirmed they would feel comfortable in raising any concerns with either the manager or other staff at the home. The complaints procedure is clearly displayed in the Reception area and within the Service User guides seen throughout the home and in peoples rooms. We looked at where the manager should keep a record of complaints, this had not been used robustly as the manager had not kept it up to date and on another occasion had torn out a page from the complaints book to keep with an investigative report into that complaint. Although we were able to locate the information about the complaints we informed the manager of the need to improve how and where information on complaints is recorded, so that information is readily accessible to people who may request it and to assist the service with auditing and learning from complaints. Information was available to show that staff receive training in adult protection and abuse awareness and staff confirmed their attendance at training. Since the last inspection the home has obtained a copy of the local area adult protection policy and staff have also received training and awareness of the Mental Capacity Act and the role Care Homes for Older People Page 16 of 26 Evidence: of specific advocacy services in the care of people who may lack capacity to make decisions. 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. The standard of the environment is good providing people with an attractive, clean and homely place to live. Evidence: We found the entrance to the home and outside areas well maintained and flowers had recently been planted in borders and pots. Information provided by the manager in the AQAA, describes how the home has a continuous refurbishment programme. We looked at some individual bedrooms and communal areas, and we found all areas to be clean, and the decoration satisfactory. The home has continued to replace carpets and all people we spoke with were satisfied with their bedrooms and en-suites and viewed that their rooms are kept clean. The home recently had an infection control audit undertaken by a local infection control specialist audit and generally achieved good scores. The home has noted where action is needed, which includes hand hygiene training. At the last inspection we identified that only half of the staff had received infection control training, at this inspection the figure of staff who have done infection control training remains the same and the manager was informed of the need to ensure this training is pursued. During the inspection we observed staff washing their hands between procedures and Care Homes for Older People Page 18 of 26 Evidence: using protective clothing. 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. Observations of staff working demonstrate that staff have the necessary skills to support the people currently living at the home. Although there are some gaps in the training programme the home plans to deal with this. The home has improved its recruitment processes and this protects people living at the home from the employment of inappropriate staff. Evidence: People confirmed to us that they feel there are usually enough staff on duty to meet their needs. One person commented within their survey that if staff are busy, they will attend to my needs as soon as possible, our observations during the inspection found people having their needs attended to promptly. We were informed that staffing levels are usually 7 or 8 carers plus two nurses on a morning shift, 6 or 7 carers and two nurses in the evening and around 5 staff on at night, which includes 1 or 2 trained nurses. Since the last inspection the manager informed us that the home has increased the hours of administrative support to 3 days per week, which has relieved the manager and staff from some administrative duties. We looked at three staff personnel files which contained the required pre-employment checks and shows the home has improved its recruitment processes. One member of Care Homes for Older People Page 20 of 26 Evidence: staff who had been appointed prior to their full CRB Disclosure being obtained confirmed they are fully supervised at all times, and were aware that they must not attend to people without this level of supervision. We saw documents, which demonstrate the home provides new staff with a comprehensive induction. Care staff confirmed that good training opportunities exist and nursing staff spoke of how they are supported to keep up to date with their professional development. Information provided by the manager shows that over 50 percent of care staff have achieved a recognised qualification in care (NVQ level 2). Observation of individual staff training plans and certificates shows that staff have attended a range of courses and study days. The manager is aware that some staff need to undertake infection control training and must now ensure this is provided promptly. The manager recognises that the training matrix (planner) needs further attention to provide accurate information on training undertaken. 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 manager, Cheryl Fenton has the skills and knowledge to manage the home and to lead the staff team to ensure peoples needs are met. Evidence: The manager, Cheryl Fenton is a registered nurse with a range of supporting qualifications, skills and experience. A deputy manager provides continuity in the day to day running of the home if Cheryl Fenton is not available. As at the last inspection, people living at the home, visitors and staff spoke of their satisfaction with how the home is managed. We looked at surveys, distributed by the home and these showed that most people are generally very satisfied with the service. Although the manager had collated results of the surveys this only showed positive feedback and did not demonstrate what had been done when people were not entirely satisfied. We discussed that the home needs to be more open and transparent when people provide negative feedback and to use Care Homes for Older People Page 22 of 26 Evidence: feedback constructively so that the service can learn and improve. We received nine surveys completed by people living at the home, some people provided comments in their surveys including:- manager and matron are very helpful if I have any queries, I am more than happy, I would like to tell you how very caring and hard working all the staff are, My needs are always met, I came for a short time and decided to stay because I like it. For the purpose of this inspection Cheryl Fenton had responded to a request by the Commission to complete an annual quality assessment document (AQAA)-this is an opportunity for providers to share with us areas that they believe they are doing well, and where they could improve. The information contained within the AQAA shows that Cheryl Fenton has some good ideas for improving and enhancing various aspects of the service. We looked at documents, which demonstrate that meetings are held on a regular basis for people living at the home and for staff to keep them informed of changes within the service, implementing good practice and where changes to practice are needed. Observation of staff files and discussion with staff confirms they have access to formal supervision sessions, which provide opportunity to reflect on their practice and to discuss training and development needs. Since the last inspection the home has appointed a maintenance person. During our inspection the equipment we saw appeared well maintained, bed rails observed in use were fitted correctly and the records we looked at, including fire safety and water temperature checks were all up to date. 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: 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 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 © (2008) 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!