Care Home: Parkside

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What the care home does well A professional assessment of need is obtained prior to people entering the home. From this, the manger undertakes an additional assessment ensuring people`s needs can be met.Staff at interview confirmed they were given sufficient information to carry out their care duties. One member of staff said "the home does well, it treats residents as individuals meeting their needs, promoting their privacy and independence, ensuring residents are happy and safe". Staff also said they worked has a team. People said there was a new cook, "food is always good and we get good suppers". One person said, "It is comfortable here, you can do your own thing". Another said, "I would like a larger room and have had discussions with the manager who is looking into it." One person interviewed said "I can approach the owner or manager if I have any concerns". What has improved since the last inspection? Requirements made on the previous inspection had been addressed, in that, care planning, assessments and medication administration had improved, however the manager recognised there was still more could be done, as stated in their Annual Quality Assurance Assessment. Some refurbishment had taken place, for example, the laundry has been upgraded with new equipment and a new central heating system has been installed. At the time of this visit, a new nurse call system was being installed and two of the lounges had been decorated. In relation to daily life a computer had been bought for people to access the Internet if required and menus had been reviewed through consultation with people in the home. What the care home could do better: Under Regulation 37 of the Care Standards Act 2000, the manager must inform the Commission for Social Care Inspection of any adverse incidents that have occurred. There have been a total of 20 accidents from 19th November 2007 to 29th July 2008 of which the Commission for Social Care Inspection had not been informed. Although medication administration had improved since the last inspection there were still minor errors in recording of medication and care planning.Some improvements have been made to the environment, however more needs to be done, for example, beds and bedding, and headboards looked worn and stained and corridors needed re-carpeting and decoration. A review of activities in the home needs to take place to ensure all age group needs are catered for. CARE HOMES FOR OLDER PEOPLE Parkside 6/8 Edward Street Oldham OL9 7QW Lead Inspector Sandra Buckley Unannounced Inspection 6th August 2008 09:30 X10015.doc Version 1.40 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 Parkside DS0000060150.V369370.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 Older People. 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. Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parkside Address 6/8 Edward Street Oldham OL9 7QW 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) 0161 624 6113 F/P 0161 624 6113 Pridellcare Ltd Ms Joan Aspin Care Home 24 Category(ies) of Dementia (6), Old age, not falling within any registration, with number other category (24) of places Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC, to people of either gender whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category: Code OP; Dementia - Code DE who are over 60 years of age (maximum number of places: 6). The maximum number of people who can be accommodated is 24. 22nd August 2007 Date of last inspection Brief Description of the Service: Parkside residential home provides 24-hour personal care and accommodation to 24 service users. The front of the home has small landscaped gardens and some seating for the use of service users. A small car park is available to the rear of home. There is another pleasant garden with a lawn and flowerbed areas at the back of the home. Bedroom accommodation is available on both the ground and first floors. There are 13 single rooms, seven with en-suite or shared en-suite toilet. There are also five shared rooms, two of which have access to en-suite toilets. In addition, all bedrooms contain a washbasin. A passenger lift is available for the use of service users and accessible toilets are available for service users who do not require the support of a hoist. Bathing facilities include one assisted bath on the ground floor, one shower and one unassisted bathroom. On the ground floor, there is a choice of two lounges, a small conservatory used as the smoking area, and a large dining room. The home charges £360 each week. The previous Commission for Social Care Inspection (CSCI) inspection report was readily available at the entrance of the home. Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes This was a key inspection that included a site visit to the home. The manager was not told beforehand that we were coming to inspect, this is called an unannounced inspection. This inspection looked at all the key standards and included a review of all available information received by the Commission for Social Care (CSCI) about the service provided at the home since the last inspection. During the site visit information was taken from various sources, including observing care practices and talking to people in the home. The manager and some members of the staff team were also interviewed. A tour of the home was undertaken and a sample of care, employment and health and safety records were seen. Comments from questionnaires returned from residents and their relatives are also included in this report The CSCI requires the home to complete an annual quality assurance assessment (AQAA) in order to demonstrate the level of care provided. The manager had completed this in full and comparisons were made with this document at the time of inspection. On this inspection the outcomes for people in the home did reflect that indicated by the manager in the Annual Quality Assurance Assessment. However, the manager had recognised what improvements could be made and was taking steps to address the issues especially in relation to daily life and the environment. The Commission for Social Care Inspection had not received any complaints about the home. The manager had received two regarding care issues, which they dealt with appropriately. What the service does well: A professional assessment of need is obtained prior to people entering the home. From this, the manger undertakes an additional assessment ensuring people’s needs can be met. Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 6 Staff at interview confirmed they were given sufficient information to carry out their care duties. One member of staff said “the home does well, it treats residents as individuals meeting their needs, promoting their privacy and independence, ensuring residents are happy and safe”. Staff also said they worked has a team. People said there was a new cook, “food is always good and we get good suppers”. One person said, “It is comfortable here, you can do your own thing”. Another said, “I would like a larger room and have had discussions with the manager who is looking into it.” One person interviewed said “I can approach the owner or manager if I have any concerns”. What has improved since the last inspection? What they could do better: Under Regulation 37 of the Care Standards Act 2000, the manager must inform the Commission for Social Care Inspection of any adverse incidents that have occurred. There have been a total of 20 accidents from 19th November 2007 to 29th July 2008 of which the Commission for Social Care Inspection had not been informed. Although medication administration had improved since the last inspection there were still minor errors in recording of medication and care planning. Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 7 Some improvements have been made to the environment, however more needs to be done, for example, beds and bedding, and headboards looked worn and stained and corridors needed re-carpeting and decoration. A review of activities in the home needs to take place to ensure all age group needs are catered for. 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. Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Professional assessment of need is obtained prior to people entering the home, ensuring their needs can be met. EVIDENCE: Three people’s files were looked at which contained an assessment of their needs from professionals. In addition to this, the manager undertakes her own assessment of people’s needs to ensure they can be met in the home. Ten questionnaires were received from people living in the home; all stated they have sufficient information on the home on which to make an informed choice. The service user guide and statement of purpose have recently been reviewed. Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Continued improvements in care planning and medication systems have enhanced the quality of care delivery. EVIDENCE: Three care plans were examined and were found to match people’s assessment of need. When specific problems had been highlighted, e.g., epilepsy, information was on file for staff reference in the causes, treatment and how this may present. Care plans also reflected people’s objectives, for example, to maintain independence, promote privacy and dignity whilst explaining to residents the care delivery being carried out. We discussed with the manager the need to ensure care plans are signed and dated. In some instances, the likes and dislikes of people were recorded and there was also evidence of professional visits. Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 11 Daily notes reflected care delivery and people looked clean and well presented. One staff questionnaire said “the service provided at Parkside is tailored to personal, social and medical needs of each service user. Care is given by skilled and trained staff. Staff enable the service user to realise their own aims and ask them to achieve these goals in all aspects of daily lives. We also allow the resident to make their own decisions and think and act for him or herself. At all times care is provided with respect and in a manner that is sensitive maintaining the dignity of service users”. Another staff questionnaire said “the home does well, it treats residents as individuals meeting their needs, promoting their privacy and independence, ensuring residents are happy and safe”. Ten resident questionnaires were retuned, eight said they always receive medical support, two usually and all said staff were always available to help. One resident interviewed said ‘They sent for a doctor if I am not well and staff look after me very well.’ Another said ‘Staff are alright, I get on with them.’ Moving and handling equipment was available to meet the needs of residents and staff were observed using safe working practices. Examination of medication procedures and administration found that practices had improved. However, eye drops, once opened, must display the date of opening and be returned to the pharmacists after the expiry date. The manager had recorded on the Annual Quality Assurance Assessment in the section could do better, ‘Improve the nurse call system. We found the system was not working efficiently, however at the time of this visit a new one was being installed. We looked at accidents in the home and how these were recorded and their outcomes. Under Regulation 37 of the Care Standards Act 2000, the manager must inform the Commission for Social Care Inspection of any adverse incidents that have occurred. There have been a total of 20 accidents from 19th November 2007 to 29th July 2008 of which the Commission for Social Care Inspection had not been informed. Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. An increase in activities would enhance people’s quality of life in the home. EVIDENCE: People who lived in Parkside felt routines in the home were flexible and they were offered choices in their daily lives. One person said, “Staff always ask what I want to wear today”; also “You can go out on your own as long has you tell them”. Another person said “I have been out to the park today for a walk”. The atmosphere in the home was interactive and a selection of activities was on offer. One staff questionnaire said “The service always meets health, personal and social care needs of our clients” also “The service does well looking after service users individually and the food is always good”. Talking to people about the activities on offer highlighted that mostly board games were played. However, a computer had been purchased for the people of a younger age group who may wish to have Internet access. Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 13 The Annual Quality Assurance Assessment completed by the manager also recognised the need for increased activities to reach all age groups and interests stating in the section what we could do better “Increase the number of outside visits and increase the activity programme to allow more involvement of service users”. Ten questionnaires were returned from people in the home, with three saying there are usually activities, two saying always and five sometimes activities. We dined with people in the home and found that individual preferences were catered for. People said there was a new cook, food is always good and we get good suppers. One person said, “It is comfortable here you can do your own thing”. A social fund is in operation with people contributing £30 a month. The manager said this contributes to hairdressing, podiatry and toiletries. However, this is not compulsory and three people in the home did not participate in this aspect. Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People felt able to raise concerns they may have and that they would be listened to. Staff training in the protection of vulnerable adults ensures the safety of people in the home. EVIDENCE: The Commission for Social Care Inspection had not received any complaints about the home since the last inspection. The manager had received two regarding care issues, which had been addressed. A meeting was held with relatives and the process and outcome recorded. The manager stated on the Annual Quality Assurance Assessment that staff recognising where a complaint may arise and acting upon it could make improvements. Ten resident questionnaires returned all stated they were aware of how to make a complaint. One person interviewed said ‘I can approach the owner or manager if I have any concerns.’ Another said, ‘I would see the boss if anyone upset me.’ Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 15 Examination of staff records and interviews with staff identified that training was provided on the protection of vulnerable adults during their induction. Some staff had completed this training through NVQ and others were awaiting training through the local authority-training department. Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. A pro-active approach is used to upgrade facilities and services in the home. EVIDENCE: Some improvements have been made to the environment and fabric of the building. The laundry has been upgraded with new equipment and a new central heating system has been installed. At the time of this visit, a new nurse call system was being installed. One bedroom was ready for redecoration. There are a number of shared rooms with privacy screens, however several of these are used for single occupancy. Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 17 More needs to be done, for example, beds and bedding, and headboards looked worn and stained and corridors needed re-carpeting and decoration. The main lounge has been re-decorated and is bright and cheerful. There is a small smoking annexe, which can be separated from main building to prevent passive smoking. The manager stated on the AQAA in the section could do better; improve surroundings with more modern furniture. Also that plans for the next 12 months were to modernise the kitchen and refurbish some bedrooms. We discussed with the manager the need for refurbishment plan with timescales to give a clearer picture, prioritise areas for refurbishment. The home retained a homely appearance with people personalising their rooms with their own furniture and possessions. Ten resident questionnaires returned said the home is always clean and tidy. One person interviewed said ‘My bedroom is very comfortable.’ Another said, ‘I would like a larger room and have had discussions with the manager who is looking into it.’ Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Recruitment procedures were robust and ensured the protection of people in the home. Staffing levels maintained positive outcomes for people. EVIDENCE: Examination of the duty rota found that names and designations of staff were not recorded. No hours were listed for cook and ancillary hours. From discussions with the manager and staff it was identified that four staff are on duty till 2pm, three cover the afternoon shift with an additional member of staff starting work at 5pm to help with meals. Two staff are on duty from 10pm till 8am. Ten questionnaires were returned from people living in the home; all said staff listened to them and acted upon what they said. Eight questionnaires were returned from staff; all said they received information in relation to the care needs of people in the home. One stated, “Training was provided which was relevant to their role”. Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 19 Six staff had completed NVQ level 2, three NVQ level 3 and one had qualified to NVQ level 4. Refresher training in moving and handling had taken place in April 2008 and staff had participated in pressure sore awareness in January 2008. The Annual Quality Assurance Assessment stated in the section could do better stated, “would like more courses available, especially in dementia care and other areas to increase the expertise of staff and optimise the quality of care they provided.” At interview staff were asked about the care needs of people living in the home. They were able to demonstrate a good knowledge of people’s needs and interests and hobbies. Two staff recruitment files were examined and found to contain all appropriate checks to ensure the safety of people in the home. Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. An open and inclusive management style seeks the views of people in the home. EVIDENCE: The manager has 25 years’ experience in care and management. They continued their professional development through attending in-house and outside training, e.g., moving and handling and administration of medication. An open and inclusive atmosphere was practiced and the views of staff and people living in the home were sought through staff and residents meetings. Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 21 Minutes of the last staff meeting showed the agenda to contain a reminder to staff to maintain hygiene standards in the home, the need for hand washing to prevent infection and for staff to ensure they arrived on time for handovers at change of shift. The last resident meeting was held on the 23rd May 2008 discussed menu planning, trips out and a new colour scheme for decoration of the main lounge and dining room. An environmental inspection took place on 9th July 2008 requirements were made which the manager was acting upon. when six There was evidence that safety checks had been carried out on equipment in the home and weekly fire alarm tests were carried out. The Annual Quality Assurance Assessment stated that senior staff had completed first aid courses when completing their NVQ level 3 qualification. Also, that a quality monitoring system had been developed and that more could be done to obtain the views of residents and their families. Financial records of monies held in the home on behalf of people were examined and were recorded appropriately. Has stated previously in this report (see section Health and Personal Care) the manager had failed to inform the Commission for Social Care Inspection of any adverse events or accidents that had occurred in the home under Regulation 37 of the Care Standards Act 2000. Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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 Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 6 Refer to Standard OP7 OP9 OP12 OP19 OP27 OP31 Good Practice Recommendations All care plans should be signed and dated to enable an audit trail Eye drops once open should be signed and dated to ensure the expiry date is not exceeded and maintain optimum benefits for people in the home. A good range of home and local based activities for service users should be provided, taking into consideration their age and capabilities. Prepare a planned programme of refurbishment with timescales. Staff duty rota should record staff designations and hours worked by cooks and ancillary staff. The Commission for Social Care Inspection should be informed of any adverse incidents or accidents to people in the home under Regulation 37 of the Care Standards Act 2000. Parkside DS0000060150.V369370.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Manchester Area Office Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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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