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Inspection on 06/11/09 for Parkwood Lodge

Also see our care home review for Parkwood Lodge for more information

This is the latest available inspection report for this service, carried out on 6th November 2009.

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

All service users receive a comprehensive pre admission assessment including visits to the service to ensure their needs can be met. Reviews take place of care plans and risk assessments, by key workers to ensure service users changing needs are known and recorded. Staff work well as a team and support service users to have good community inclusion and participate in purposeful and meaningful activities including education and voluntary work opportunities. Staff are recruited safely and ongoing training and supervision takes place to ensure staff work to the services expectations. .

What has improved since the last inspection?

A new manager is in post who is now registered. Staffing levels have increased and all of the care plan information has been reviewed so it is more person centred. Risk assessments are comprehensive and staff receive training to enable them to understand the changing needs of the service users. Refurbishment of the environment continues to take place to provide service users with comfortable surroundings.

What the care home could do better:

Following the visit and feedback we received, we found there were no recommendations or requirements to make. The manager advises us they will continue to work on the quality assurance system to enable the service users to continue to receive excellent outcomes.

Key inspection report Care homes for adults (18-65 years) Name: Address: Parkwood Lodge 181 London Road Waterlooville Hampshire PO7 7RL     The quality rating for this care home is:   three star excellent 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: Kathryn Emmons     Date: 0 6 1 1 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 Adults (18-65 years) Page 2 of 26 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 Adults (18-65 years) 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 Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Parkwood Lodge 181 London Road Waterlooville Hampshire PO7 7RL 02392268073 02392268073 parkwoodlodge@truecare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Truecare Group Ltd care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 7. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia (MD). Date of last inspection Brief description of the care home The home supports up to seven service users who have mental health disorders and/or learning disabilities, including people with disabilities within an autism spectrum. This support comprises assisting them to live comfortably within the community and to find ways of recognising and coping with their disabilities and challenges. The premises are a detached property with parking at the front and enclosed garden at the rear. There is a lounge, conservatory and kitchen/dining area. Each service user has a single bedroom with full en-suite facilities. Three of the bedrooms are on the ground floor and seven are on the first floor. A passenger lift connects the 2 floors. Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 7 Brief description of the care home Twenty-four hour care is provided with two members of staff on duty at night. The home is owned by an organisation that has a number of other similar residential homes in the county. The manager therefore has the support of additional professional services e.g. an operations manager, a clinical services manager and human resource services. Care Homes for Adults (18-65 years) 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We visited the service on Friday 6th November 2009 from 9.30am until 4:45pm. The AQAA (Annual Quality Assurance Assessment) was received on time. We were able to use the information this contained to help us prepare for the inspection visit. Five people using the service were involved in our key inspection . We spoke with them during our visit. We also spoke with four staff members throughout the day. The Responsible Individuals representative was present towards the end of the visit so was involved in feedback with the registered manager. Care Homes for Adults (18-65 years) Page 6 of 26 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 Adults (18-65 years) Page 7 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. Service users have information about the home available to them in a suitable format. Service users are able to visit the service to see if the home is suitable for them and can meet their assessed needs. Evidence: We looked at three files belonging to service users. We could see that prior to admission to the service they had been assessed by the manager using a set format. There was also a lot of information obtained from other health care professionals who had been involved in supporting the service user. Currently the manager is supporting a new service user to live at the service. The statement of purpose and service user guide have been updated and these have been given to the prospective service user. This means that the service user can have an understanding of the services provided at the home. The prospective service user has had numerous visits to the service to see how they feel about living at Parkwood Lodge. The manager said that this also helped with seeing how other service users got along with the new service users. From looking at files we could see that contracts were in place and these had been signed by the service user or their representative. This means that there is a Care Homes for Adults (18-65 years) Page 9 of 26 Evidence: formalised system for informing service users of their rights. Care Homes for Adults (18-65 years) Page 10 of 26 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported to have their rights upheld and make as many choices as possible regarding how they spend their time. Service users are supported to make decisions and risk assessments enable service users to remain safe as possible. Evidence: We received comment cards back before we visited the service and during our visit we were able to speak with service users . Comment cards indicated that service users felt they had choice over many aspects of their lives and during our visit we received many positive comments. These included I am out to lunch in a minute I could chose if I wanted to go, I can lie in bed until late if I want and its OK, I help in the kitchen and I dont have to if I dont want to . Care plan folders are in place and we could see that service users had been very involved in their care plan production we saw signatures and entries written by the service users to say how they felt about their care plans. Alongside the care plans were comprehensive risk assessments. These had been agreed with service users and Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: where there were restrictions on activities it was clearly explained how this protected the service users. The manager and staff explained to us their involvement in the careplans and how a key worker system is in place to provide continuity for service users. Service users we spoke with were able to tell us who their key worker was and the activities they carried out with their key worker. These included shopping, assistance with keeping their rooms tidy and help with setting personal goals and wishes. Service users said they had weekly house meetings where they could discuss any issues together. Minutes are maintained of these meetings and we could see what had been discussed and what action had been taken . Care Homes for Adults (18-65 years) Page 12 of 26 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users have their dietary needs catered for and they make decisions regarding the meal arrangements in place. Service users are able to choose what education and occupation activities they engage in and staff know how to support service users to carryout these activities. Evidence: Service users we spoke with told us that they were able to access the community when they chose. A couple of service users chose not to participate in any education or work programmes. The AQAA informs us that service users are supported to engage in college or voluntary work placements. Since the last inspection one of the service users has started work in a voluntary role. The service has provided a staff member to support the service user and has also provided Crisis Cards so that the people at the service users place of work can support the service user if this is needed. This means that the manager is identifying possible barriers to people Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: engaging in purposeful activities and putting systems in place to minimise the barriers. One service user told us I could go to day centre more than I do but Im happy with what I do I prefer to stay at home. Service users told us they had been given opportunity to go on holiday and were in discussions with staff to plan to go away for a few days again this year. One service user told us they had chosen to go for day trips out instead of a week away as this was what I wanted to do. Service users told us they were able to chose the meals they had and took it in turn to make the tea time meals. During the visit we saw people making their lunch with minimal help. One service user told us they were working towards doing their own shopping and making all their own meals. We spoke with the manager about this and she confirmed that this was the overall aim but that a lot of support was in place for the service user so they could gain independent skills while still being supported so their needs regarding nutrition could be met. The AQAA tells us that staff work with service users to promote healthy eating and one service user told us they had joined a local slimming group and was being well supported by the staff at the service to follow the plan they had been given. All of the shopping is carried out locally and staff support service users to carry out the shopping weekly. Care Homes for Adults (18-65 years) Page 14 of 26 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users receive their personal support as they choose and staff are clear on how to support service users . Access to health care support is very good and the manager ensures that the organisation provides mental heath support where necessary.Medication systems ensure service users receive their medication safely. Evidence: Service users tell us that they receive support from staff in a very positive way. We were given many examples during our visit from service users regarding the support they receive. Some of the comments included I ask for help when I need it but you always have someone around to help, I have lots of help but am given time to try and do things for my self which I like, I like it here and I get to do a lot of things I wouldnt do if I wasnt here and had no help. Care plans give clear details regarding what level of support service users need and how this support is to be carried out. Reviews always cover how support is delivered and if there can be any improvements in how support is provided. We saw many examples in care plans of the support being resident led and the level of support given varied depending on how well the service user was when support was needed. Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: The organisation has it own psychologists who meet with service users regularly. Through these meetings staff produce risk assessments and care plans to provide the right support to service users. Service users told us they visit the opticians and dentist locally and all of the residents are supported by the staff to attend well man and well woman clinics. We could see from reading the care plans for health care support that there were robust systems in place for the community mental health team to provide support and guidance for staff. There is a comprehensive training programme in place regarding mental health so that staff can continue to provide the support service users need when they have changes in their mental health conditions. Currently none of the service users are able to self administer their medication .Risk assessments have been carried out and these are reviewed monthly. All medication is administered by senior care staff who have reviewed medication training. We looked at medication sheets and could see these had been completed correctly. Staff we spoke with confirmed they had received training and the manager confirmed that regular audits were carried out for medication. The AQAA tells us that there is a medication policy in place and all staff are aware of the expectation to follow this to ensure service users receive their medication safely. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. Service users can be confident that their concerns will be listened to and acted upon. Staff are trained in safeguarding adult procedures and service users are protected from harm. Evidence: We saw a copy of the services complaints procedure was on display and service users told us they could raise any concerns with any member of staff and they would be addressed promptly. We were told by the manager that any concerns will be investigated and responded to and service users would be advised of what action was going to be taken to any issues they had raised. Staff had received training in safeguarding adults and we saw certificates for this on staff files and when we spoke with staff they confirmed they had received this training . We asked staff several scenarios for safeguarding adult issues and their responses to these were appropriate. The manager informs us through the AQAA that they have worked well with other agencies if there have been safeguarding issues. Care Homes for Adults (18-65 years) 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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. Service users live in a clean and comfortable environment. Systems are in place to ensure the environment is safe and does not place service users or staff at risk. Service users have control over the environment and have been able to personalise their own rooms. Evidence: The home is located in a residential area near the local town centre. Service users we spoke with said they thought the home was always clean and tidy and that even if they choose not to help with cleaning the staff would always ensure the home was clean. We spoke with service users in several areas of the home and all of these were found to be tidy and no obvious hazards noted. Since the last inspection new lounge furniture has been purchased and two of the service users told us that they like the new lounge and its comfy and we can all watch telly together if we want. Decor was of a good standard and the manager advised that ongoing refurbishment is taking place to ensure a high standard of decor is in place through out the service. We did not view any service users bedrooms but service users told us they were very happy with their rooms and had been able to personalise them with their own choice of decor and personal possessions. Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: Staff told us they had a responsibility on each shift to ensure the home was clean and tidy. In the kitchen there were clear systems in place for the use of chopping boards, fridge temperatures and ensuring high food hygiene standards were maintained. The AQAA informs us of the servicing arrangements for equipment such as electrical items and fire safety systems.Staff confirmed they had received training in infection control and fire safety. Care Homes for Adults (18-65 years) 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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. Service users are supported for by trained and enthusiastic staff. Robust recruitment procedures keep service users safe.Ongoing training means service users will receive care which is in accordance with current care practises. Supervision sessions enable staff development and training needs to be identified. Evidence: Service users told us they felt supported by the staff and that there were always enough staff on duty. The AQAA informs us that bank staff are used to cover sickness and holidays and all of the staff bank staff are regular staff. This means that service users receive continuity in their support. We looked at four duty rotas and could see that support staff numbers were consistent. Comment cards we received back from service users and comments we received during the visit were very positive regarding staff. These included, They are all very good, I like them all they are very nice to me, You can have a laugh with them, They can sit with you for a chat and thats alright, I have time to sit and talk with them and I like that they arent rushed. Staff we spoke with said they felt they had enough staff on duty and there was always a clear line of leadership and staff were always clear on their job roles and what was expected of them. We saw very good interactions between staff and service users. It was clear that staff had very good rapports with service users and understood their individual needs and personalities. Interactions were valuing of the service users and Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: staff were always giving service users choice and encouraging the service users to make decisions and to be as independent as possible. Since the last inspection many new staff have been employed. During our visit one new member of staff was carrying out their induction. We looked at three recruitment files for staff that had been recruited since we last visited. We could see that the necessary checks had been carried out such as two written references, a CRB(Criminal records bureau check) and a written application form. We also saw evidence of an induction course and shifts where new staff had worked alongside established staff to learn the needs and support preferences of service users. The manager has introduced a new induction programme which meets a nationally recognised standard for induction. This means that staff are provided with clear training to enable them to learn the skills needed to provide care safely and in line with current care practises. A training plan is in place and staff are working towards National Vocational Qualifications in Social and Health Care (NVQs) This means that they will have an enhanced skills and knowledge base which may provide a better quality of care for service users. Already over 50 of the staff have this qualification. A supervision system is in place and all staff receive supervision at least every eight weeks. This provides an opportunity for staff to discuss any development needs and for line managers to discuss support needs of service users and the support workers progress. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 service is managed by a competent and enthusiastic registered manager. The manager has a good rapport with service users and places service users at the centre of any decision made regarding how the service operates. Systems are in place including up to date polices and procedures which enable staff to work and service users to live in a safe environment. Evidence: The registered manager for the service is Ms Lian Edwards. The manager has been registered since May 2008. Service users we spoke with said they got on well with the manager and She is very nice and we speak to her a lot, I like Lian she is good and you can go and see her whenever you want and Lian helps me and she is always friendly. Staff said the manager was approachable and that paperwork and procedures were always updated and available for staff to refer to. One staff said I get on with Lian very well, she is a fair manager. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: There is a health and safety system in place and the AQAA informs us that all servicing of equipment including electrical appliances and fire safety equipment is carried out regularly. A health and safety audit is carried out yearly and this is reviewed and action taken where necessary. A quality assurance system is in place and the Responsible Individuals representative visits the service monthly to provide a report on the conduct of the service and provide support to the manager. Service users have house meetings where they can make their views known and annually questionnaires are sent to relatives and health care professionals so their views on the service can be obtained. These are included in the services business plan for the following year. Care Homes for Adults (18-65 years) 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 Adults (18-65 years) 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 Adults (18-65 years) Page 25 of 26 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). 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