Care Home: Parklands Nursing Home

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What the care home does well People within the home looked well cared for and all were appropriately dressed. People that use the service were individually assessed prior to admission to the home and care plans were in place, this ensured their needs would be met. Staff spoken to had a very positive attitude to the care they deliver. Staff were observed to carry out their duties in a professional manner, showing kindness and consideration for each person needs. A number of people said they were happy with the home and the care provided and that staff were very kind and supportive and feel that staff worked really hard to make it a nice place to live.The environment was clean and tidy looked homely and comfortable. Regular opportunities were available for people to participate in a wide range of activities in the home, and in the wider community. What has improved since the last inspection? The two requirements made on the last inspection had been addressed. They also have improved the communal areas of the home by decorating and refurbishing a number of areas. What the care home could do better: Ensure the manager goes through the registration process and that they are supported to complete the NVQ 4 in management. Key inspection report Care homes for older people Name: Address: Parklands Nursing Home 26 Ellison St Thorne Doncaster South Yorkshire DN8 5LD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Janet McBride     Date: 0 9 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 23 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Parklands Nursing Home 26 Ellison St Thorne Doncaster South Yorkshire DN8 5LD 01405812233 01405818168 the.parklands@fshc.co.uk www.fshc.co.uk Four Seasons Homes (No 6) Limited (A wholly owned subsidiary of Four Seasons Healthcare) care home 40 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 40 The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Parklands is a care home providing residential care and accommodation for older people. The home is part of the Four Seasons healthcare group, and is located in Thorne on the outskirts of Doncaster. Adjacent to the local park and within easy reach of local shopping centre and is well placed for community facilities, including local primary health services. The building is a converted and extended property with two Care Homes for Older People Page 4 of 23 Over 65 40 0 Brief description of the care home units. High proportions of the bedrooms are single with en suite facilities. Fees range from £398:00 to £425:00 per week, as at July 2009,and additional charges are made for hairdressing, toiletries, magazine, newspapers and private phones. Further information relating to these charges may be obtained from the homes manager. Information about the home is provided to people who use the service and their representatives in the form of a statement of purpose and service user guide. Leaflets and other general written information were available at the homes reception area. Care Homes for Older People Page 5 of 23 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 two stars. This means that the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. One inspector carried out this Key Unannounced Inspection, which took place on the 9th July 2009 from 09:20 am to 16:00 pm. Prior to the inspection the home submitted an Annual Quality Assurance Assessment (AQAA) this gives information regarding the home and services provided. This document gives the service the opportunity to tell us what the home did well, what had improved and what they were working on to Care Homes for Older People Page 6 of 23 improve. Other pre-inspection work was carried out on the information received and other relevant documentation, for example analysis of statutory notifications and complaint records. During the inspection various aspects of the service were checked. Care practice were observed, documentation and records were examined, for example medication, complaints, accident records, staff rotas and staff training files. Three care plans were cross-referenced with other relevant documentation relating to those people who use the service, to evaluate how well their care needs were met. Information was gathered from as many different individuals as possible that had contact with people within the home, discussion with the manager and five members of staff. The majority of people living at the home were seen throughout the day and several were chatted to. Three people within the home were individual spoken to. They were asked to comment on the standard of care, staff skills, attitude, and how the needs of people using the service were met. The inspector wishes to thank people living in the home, the staff and the manager for their assistance and co-operation. Care Homes for Older People Page 7 of 23 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 23 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 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People within the home had been individually assessed prior to admission and they had been assured that the home could meet their needs. Evidence: Three care plans showed that people that use the service were fully assessed prior to moving into the home, with other professionals involved where required. People within the home confirmed that they or their relative had an opportunity to visit the home and have a trial visit before making a choice about moving in on a permanent basis. The manager said that people using the service were issued with a contract/statement of terms and conditions these contain a scale of charges and any extras that people had to pay for, all of which is documented in this report. Care Homes for Older People Page 10 of 23 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 provided staff with the information they needed to meet the care needs of people that use the service, this ensured that peoples needs were identified and met. Staff ensured that all policies and practices were followed when medicines were administered. Evidence: Three care plans that were case tracked and cross referenced with medication records, accident records and any other relevant information. Health,personal and social care needs were set out in an individual plan of care. Lots of information was gathered from professionals and family. Care plans contained health care needs and any specialist intervention. Various assessments had been completed for example nutrition and dietary needs were clearly recorded along with weight charts. Consent and capacity were assessed as well as spiritual and end of life care. The District Nurse provided the main link to all medical services including pressure area care, continence advice and general health checks as required by the G.P. Records showed when people using the service were seen by GP, Care Homes for Older People Page 11 of 23 Evidence: district nurse or attended hospital. Care plans seen were generally found to be comprehensive concise and easy to follow, with legible records kept. Medication policy and procedure were discussed with the manager, records checked and observation of medication being administered. Examination of records, storage, and recording were found to be satisfactory. Observation of a member of staff administering medication was satisfactory with the exception of them leaving the trolley unlocked while they gave medication to some people, although they were in the room advised that good practice is to lock the trolley every time they . The manager said they complete medication audits on a weekly basis and the local pharmacist that supplied the medication system visited periodically to undertake audits and give advice to staff.The home had an up to date BNF for staff to refer to. Staff responsible for the administration of medication had completed the accredited medication training. Care Homes for Older People Page 12 of 23 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. Regular opportunities were available for people to participate in a wide range of activities in the home, and in the wider community. Meals offered were healthy and nutritionally balanced. Likes and dislikes were catered for within the menus offered. Evidence: Activities were organised on a weekly basis by the activities coordinator, who said they try to provide a range of activities that is stimulating and enjoyable for people. Examples were given of the kind of activities that take place at the home, a number of ladies said they enjoy bingo and some enjoyed quizzes. Motivation comes in monthly and were due on the day of the visit. Some of this activity was observed. They did floor games and exercises. Most people were interacting and seem to be enjoying the activity. The home hires a bus and have various trips out. People within the home said they had been to the seaside and garden centres. Many examples of good practice were seen from the staff on duty while observing the general routines of the home. They were observed to knock on doors before entering, and interacted with people within the home with respect, addressing people by their preferred name. A number of people within the home said they had chosen the bedroom some said they had chosen the decor and that the room is kept clean and tidy.People said staff Care Homes for Older People Page 13 of 23 Evidence: are helpful and are very supportive, all comments were very positive about the home and the care received. Menus were available and people were asked what they wanted. Observations during mealtimes, confirmed the food was well presented, lunch was unhurried and assistance was given to people if required. Comments from people spoken to at lunchtime said, they had enjoyed their meal and liked the food at the home and confirmed they had choices every day. Care Homes for Older People Page 14 of 23 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 had a written complaints procedure which was displayed within the home this ensured that people who use the service and their families had details of how to make a complaint. The home had policies and procedures in place on safeguarding vulnerable adults this promoted and protected the people who use the service. Evidence: The home had a written complaints procedure which was displayed in the reception area of the home. There was an appropriate system for recording complaints, the outcome and the action taken. Record showed one complaint since the last inspection which the manager confirmed this was investigated with feed back to the complainant. Views of people who were residing at the home said if they were unhappy they would talk to the manager. Policies and procedures were in place regarding the protection of vulnerable adults. Discussion with staff confirmed they were aware of safeguarding polices and procedures those spoken to were able to verbalize the action they would take on receiving any allegations. Training files and staff confirmed they had either received safeguarding training or were due to attend a course in the future. Care Homes for Older People Page 15 of 23 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. People who use the service live in a comfortable and accessible home which was clean and tidy and provided a well maintained environment. Evidence: A tour of the premises looking at the homes accommodation, assessing the general fabric, furniture and fittings at the home found that a number of requirements made on the last inspection had been addressed. During a tour of the premises it was seen that the company had upgraded all communal areas. The manager said they continue to improve the garden area for residents. Since the last inspection a maintenance and renewal plan as been implemented, with specific timescales to show that the premises are audited and being regularly maintained and refurbished. Care Homes for Older People Page 16 of 23 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. Staff had undertaken basic and induction training, which ensured that they had the skills and knowledge to fulfill their roles within the home. This ensured people at the home were supported and protected. Evidence: Staffing was discussed with the manager and duty rota examined. Which clearly identified staff within the home and their role, including domestic kitchen and laundry staff. All staff that provided personal care were over eighteen years old. Observation on the day, examination of duty rotas demonstrated there were sufficient staff to meet the needs of people who use the service. The homes recruitment procedure was discussed with the manager and records of four members staff files were checked. This established that the homes process for recruitment meets all the requirements of legislation and employment law. Two references, Criminal Record Bureau (CRB) Protection Of Vulnerable Adults (POVA) checks were made prior to being employed. Each member of staff had an individual training file, these were examined and training opportunities were discussed with the manager and five members staff. Staff confirmed they had received induction to the home. Training records showed that a Care Homes for Older People Page 17 of 23 Evidence: number of staff had received updates and undertaken various training courses since the last inspection. Records indicated that a number of the staff team had achieved National Vocational Qualification level 2 in care (NVQ) with other members of staff continuing to work towards attaining NVQ level 2 in care. Care Homes for Older People Page 18 of 23 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. People who use the service were protected by sound management practices. Policies, procedures and training practices ensured that people using the service were safeguarded and protected. Evidence: Since the last inspection the homes has a new manager who is waiting to go through the registration process with Care Quality Commission to be the Registered Manager for the home. She has worked at the home as deputy manager for the passed year and had completed NVQ level 3 in social care and is waiting to commence an NVQ level 4 course in management. The manager said she operated an open door policy, to ensure she was accessible to staff, relatives and people that use the service. Comments from people within the home and staff suggested that the manager was very approachable and supportive. People receiving care stated their satisfaction with the home and care provided. Quality assurance systems were in place, the home undertakes a number of audits, Care Homes for Older People Page 19 of 23 Evidence: which were completed by the manager or regional manager on a regular basis for example, yearly audit that covers most issues from training to maintenance within the home. Monthly audits were also completed on medication records, care plans, accident reports and regulation 26 visits were completed with reports available to read. The financial interests of people were discussed with the manager, administrator and records checked. Some people within the home had their own bank accounts these people were assisted with their finances by relatives. Other monies were in a noninterest account, with records of accounts and receipts available for each individual person on the homes computer system. The administrator completed a monthly audit, which is sent to the regional support administrator within the company. Supervision of staff was discussed with the manager, staff on duty and records checked, which showed staff received formal supervision, and yearly appraisal on a regular basis. There were policies and procedures, which promoted the health, safety and welfare of people within the home. Staff and the providers undertook all necessary health and safety checks, which promoted the health and well being of people who use the service. Health and safety was discussed with the staff on duty and various records were examined. The home was maintained, checks were undertaken for example fire prevention, all records were up to date and satisfactory. Care Homes for Older People Page 20 of 23 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 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 9 31 Staff should lock the medicines trolley every time they leave it to administer medication. The Registered manager to complete NVQ 4 in management, to ensure they have the skills and experience necessary for managing the care home. Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 23 - 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. 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