Inspection on 12/05/10 for Parkside
Also see our care home review for Parkside for more information
Due to difficulties updating our database, this is probably NOT the latest inspection report for this service. Please check the CQC website instead. We hope to resume regular updates of BestCareHome soon.
The following inspection below was carried out on 12th May 2010.
CQC found this care home to be providing an Excellent service.
The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.
What follows are excerpts from this inspection report. For more information read the full report on the next tab.
What the care home does well
People living at Parkside have their care and support needs thoroughly assessed before they move to the home. This helps to make sure that the home will be suitable and able to meet their needs and their expectations. We found that these assessments are reviewed and kept up to date in order to meet the changing needs of each resident. We looked at a sample of care plans for some of the people that use this service. They are generally based on the findings of the care needs assessments, but are updated as the resident settles into the home and staff become more aware of individual preferences. Care plans are developed and written in a very person centred way. There is detailed information recorded regarding what people can or cannot do for themselves, clearly identifying individual needs and wishes, whilst supporting people to be as independent as possible. Consideration is given to people`s personal preferences, choices and routines. Care plans contain elements of nutritional assessments and risk assessments. Nutritional assessments are undertaken with residents and the plans for this element of their care and support are also reviewed monthly with them. Where concerns are identified, people are monitored by regularly reviewing their food and fluid intake and close monitoring of any weight gain or loss. Daily notes record that the manager seeks the advice and support from relevant health care professionals when needed. The people taking part in our assessment of the home told us that they `always` get the medical support they need, when they need it. The risk assessments identify where people may have a problem with their mobility and need the support of staff to help them accomplish certain activities safely. Where special equipment such as handling hoists or pressure relieving equipment are needed, their use is documented, together with strategies for staff to follow. This helps to make sure that both safe and the residents they are supporting are safe from harm or injury.Staff have received training in a variety of relevant subjects, including implementing person centred care planning. This helps ensure people are supported to exercise increased choice and control over their lives and the plans made to support them. One of the people we spoke to during our visit told us; `I am very well looked after, staff are very good. I can go outside when I please as I like to sit and watch what is going on. I can have drinks or anything when I want, the staff are very helpful.` We also observed some of the staff working with the residents during our visit. We noted that staff were attentive and friendly towards the people living at Parkside. We saw good interaction between staff and residents and they appeared very comfortable with each other. People were asked about their personal care needs with sensitivity and dignity. Where people needed support from staff this was carried out gently and in the residents own time, there was no rushing or impatience from staff. The manager told us of the work that has been done at the home with regard to helping people who may have dementia. More appropriate colour schemes, new carpets and signage have been introduced. These measures have helped residents to maintain their independence and control over their own lives. Further improvements of this nature are planned and the manager told us that picture menus are to be introduced to help people when choosing their meals. During our visit to the home we carried out a short audit of the way in which people`s medicines are managed at the home. Senior staff are responsible for managing the medication kept at the home, including the maintenance of records for the receipt, disposal and return of medicines, to and from the pharmacy. Staff with the responsibility of administering medicines have undergone training to help them undertake this task safely an additional safety measure is in place and the administration of medication is witnessed by a second member of staff. Other systems in place, that help prevent or reduce the risk of medication errors include colour coded records and medication packs and a photograph of each resident is included on their medication record to help ensure correct identification. Where people have been prescribed medicines that are given `as and when required`, such as headache remedies for example, protocols are in place and included in the medication records. We looked at the way in which the home keeps `controlled` medicines. There is secure and appropriate arrangements in place. We looked at some of the records for this type of medication, the register had been maintained accurately and the `stock count` was correct. There is a complaints, compliments and suggestions procedure in place at the home. The manager told us that she has not received any complaints. Staff working within the home are provided with training to help them understand the complaints procedure. People we spoke to or who returned surveys told us that they know about the complaint process. They also said that staff `always` listen and act upon what is said to them. The manager holds residents meetings and this provides another forum for people to air their views or raise issues they may have. The manager and staff at the home are aware of the Safeguarding of Vulnerable AdultsGuidelines and procedures. There is a clear process in place at the home and the manager has made referrals to social workers where necessary. The manager is aware of other legislation and guidance such as the Deprivation of Liberties process and has applied for assessments for some residents at the home. This helps to ensure that their best interests are protected.
What the care home could do better:
Although the information recorded in individual care plans is generally up to date and accurate, there were some areas where the manager could make improvements. Food and fluid intake charts, cover only the main meals of the day and mid-morning/mid afternoon drinks. The charts refer to `small amount eaten` or `refused` but give no indication of what a small amount might be or that alternatives were offered or that food and drinks are offered at different times. Where records indicate that people have lost weight unintentionally, there are no clear indications that they are provided with an enriched diet or high calorie snacks. We saw that some people`s individual risk assessments could be more detailed, particularly where people may be at risk of falling. There should be clear strategies for staff to follow when assisting people up from the floor, particularly where challenging or unco-operative behaviour may be displayed. One of the residents at the home has a risk assessment in their care plan relating to their medication. A copy of this should be included in the medication records, to help ensure all staff are fully aware of this potential problem and are able to manage it safely. In one of the care plans we looked at it is recorded that the resident has an ointment prescribed for twice daily use, when required. This medication is not included on the medication administration records, although there are some records in the care plan. The use of this cream is not detailed in the care plan either but there is evidence to suggest that staff administer it. The manager should ensure that the use of all medications and the administration of them are clearly and consistently documented so that people receive their treatment as their doctor intended. Records show that the manager notifies us of most of the serious incidents that occur at the home as required. Where relevant, accident records are completed and other professionals such as social workers and the community mental health team are consulted and the manager told us that the home has a good working relationship with these teams. However, some of the records we looked at indicate that the manager may not always notify us of aggressive events that happen between service users and this is another area that would benefit from review by the manager. The manager is hoping to employ an activities coordinator to help improve the social life for people who live at Parkside. Volunteers and Age Concern currently have an input to interesting social and leisure activities at the home but this is an area where the manager wishes to make further improvements. The manager also told us that she would like the opportunity to `feedback more frequently with service users and families so that residents and relatives feel confident that their comments or concerns will be listened to and acted upon.`