Inspection on 10/10/06 for Parikia Residential Care Home

This inspection was carried out on 10th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Parikia Residential Care Home 24/08/07

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Parikia APL 70 Dawlish Road Teignmouth TQ14 8TG Lead Inspector Stella Lindsay Key Inspection (unannounced) 10th October 2006 10:30 Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 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 Parikia APL DS0000067447.V310886.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 Adults 18-65. 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. Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parikia APL Address 70 Dawlish Road Teignmouth TQ14 8TG 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) 01626 770189 Mr Mark Brandwood Mrs Esther Brandwood Mr Simon Ellis-Robbins Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Mr Ellis-Robbins to complete NVQ4 in care. 1. Age range 16-45 years Date of last inspection 25/02/06 Brief Description of the Service: Parikia is a large detached house on the cliff road above Teignmouth. It is on the main Teignmouth to Dawlish road, which is a bus route. The house is spacious, with large communal rooms and some good-sized bedrooms. All bedrooms are for single occupancy. There are workshops adjoining the house, and a basement is used as a games room. There is a garden and a car parking area. Parikia cares for up to 12 younger adults with a learning disability. Parikia is organised around the provision of activities, some in small groups, some for individuals. These include many outdoor activities, including horticulture, boating, and trips to sea and moor. Indoor activities include cooking, and residents have access to the home’s kitchen, with staff supervision. Plans are made with residents for their weekly programme, which they are then expected and encouraged to adhere to. This service is aimed at people who enjoy activities, who may need help with motivation, and who may wish to work towards independence. It is not suitable for people who are unable to cope with the level of risk and responsibility which comes with this way of living, including people who are too stressed by changes in plans or by having to wait for others to be ready. Staff are committed and have good communication skills. By night they are on sleeping-in duty. Fees range from £700 to £1200 per week, according to individual need. Prospective residents and their representatives are advised of the availability of inspection reports on the Commission for Social Care Inspection (CSCI)’s website, and given a copy if they are unable to access this. Parikia’s Service Users’ Guide is offered to potential new residents. Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced, and took place over three days in October 2006. It involved a tour of the premises, discussion with or observation of all ten residents, six staff on duty, the Registered Manager, Mr Simon Ellis-Robbins and the Service Providers, Mark and Esther Brandwood. Care records, staff files, health and safety records, and the medication system were examined. Comment cards and surveys were received from staff, health and social care professionals and other regular visitors to the home, and their views are represented in the report. The Manager had provided information prior to the inspection. This was the first inspection under the new ownership. All core standards were inspected. What the service does well: Parikia is a big house, where all the residents have their own room and lots of other places to go and do things. The staff are very nice and the residents say they get on well with them. The staff take good care of people who are ill, or who need medicines to keep well. They help people to look after themselves, and make sure they look nice. There are lots of different things to do. Some residents enjoy outside work at ‘The Project’, learning to use tools and growing vegetables. Some go to college or clubs. Some like swimming, boat rides, and going to the beach or Dartmoor. Staff listen to what residents have to say, and they meet together most Sundays to talk about things. All residents have care plans. The Manager has written down what help they need, and what they really like doing, so that they can make plans to do these things. When anyone has complained to the Manager about something that has upset them, he has investigated it and found out what must be done to put it right. Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: At Parikia, residents have been expected to go to their rooms before supper, for ‘quiet time’. Not everybody wants to do this, so residents and staff should get together to decide what to do instead. The home has advice written for staff, telling them what to do if they think one of the staff may have done something that might harm a resident, but it is written wrongly. The Manager must write it out properly so that people know what to do if he is not there to tell them. Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 7 Some curtain rails are falling off. Each room should have a curtain rail that suits the person who lives in that room, so that they can pull the curtains themselves. Some baths and hand-basins do not have a shiny surface that is easy to keep clean. One has a small hole. All baths and hand basins should be kept clean, so that there is no danger of dirt making people ill. There must always be enough staff to help the residents, especially in the early mornings, to get the day off to a good start. When new staff come to work at Parikia, they must not start work until the Manager has made sure that they are safe to come to work here. The Manager must make sure that the staff go on training that is specially designed for the work they do, so that they know the best way of helping the residents. The Home owners must give the Manager a job description. This is a list of the things he has to do, so that everybody knows. This is because he sometimes has to make important decisions. 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. Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home needs to make clear in its information the limits as well as the benefits of its service. 1,2 EVIDENCE: The Service Providers are revising their Statement of Purpose to ensure clarity about the nature of this service, what is offered, and who may not be suitable to benefit. There have been no admissions since the last inspection. The home has a format for assessing prospective residents before admission. This is comprehensive and includes any restrictions on choice which may need to be agreed on the grounds of residents’ welfare, communication needs, current education and training, and has each section summarised in plain English, to help the prospective resident to understand. Information would be gathered initially from the person and their family, and from the Care Manager involved in arranging the placement. All admissions are on a trial basis. Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning and risk assessment are carried out carefully in consultation with residents, and their goals and aspirations are considered and recorded. 6,7,9 EVIDENCE: All residents have detailed care plans which contain resident profiles, risk assessments, and assessments by health professionals. The Manager is in the process of producing an improved version. Staff expressed interest in being involved with residents’ Personal Care Plans. One of the Senior carers is writing a summary about each resident and their care needs, particularly for the benefit of new staff. Medical needs plans are also being compiled. Each resident has a summary of their medical history and current medication prepared in case of hospital admission. Care plans are kept securely in a store-room beside the care office, and are available for staff to see. Records show that care plans are reviewed within the home six-monthly, if changes have not made this necessary at an earlier date. Key workers amongst the care staff are involved in these. Staff comments and client comments are recorded. Any change that is needed or Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 11 suggested is discussed, and the person’s view of their quality of life, their needs and aspirations, and any ways of improving their contacts with their family and any other significant people. All staff who returned surveys to the CSCI said that they are sometimes required to care for people whose needs are outside their area of expertise. Three residents’ care needs were being reviewed during this inspection, as the suitability of Parikia for meeting their needs was in question. The management team have a ‘can-do’ approach, and while it is good to see a positive attitude towards problem-solving, they are now aware that the limits of this service must be recognised. White boards had been used for displaying plans of activity for each day. These had been taken down for the redecoration of the dining room, and were still waiting to be fixed to the wall. The Manager stated that there are plans to put up a board showing with photos which staff are due to come on duty, to give reassurance to the residents. Residents’ meetings have continued, most Sundays. One resident has had an independent advocate. The Manager stated that he is seeking people who are prepared to fulfil this role for more residents. Staff and residents were pleased that ‘pigeon-holes’ have been provided for their post, and post is taken individually to residents to ensure that they receive and understand it. Residents have safes in their rooms, with a keypad. Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has a strong commitment to enabling residents to develop skills and abilities. 12,13,14,15,16,17 EVIDENCE: Staff and residents were pleased about their work at ‘The Project’. This is a site which has been made available for residents to engage in outside work of various kinds, including use of power tools. They have produced vegetables which are brought home for the table. They were also entered in a local produce show, and won prizes. Photos are on display, showing a resident receiving his certificate. Some residents thoroughly enjoy this activity, while some prefer to go down to the beach. The swimming pool is also popular. With the winter coming on, thoughts were moving to planning indoor activities. Two of the Senior staff were planning to introduce craftwork, using the basement room. Some residents enjoy working in the kitchen, and were seen to be working well with supervision. Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 13 Some residents are committed to regular attendance at Centres and clubs, including Keep Fit. Two residents had been attending South Devon College, and the Manager was optimistic with regard to the benefit of future collaboration with the college. Contact with residents’ families is supported. Staff enable residents to meet with friends at social events. Friendships within and outside the Home are supported, with staff remaining alert to the possibility of exploitation. Parikia has a good record of arranging holidays for residents. This year the whole group went at once, to Butlins in Minehead. The residents said that they enjoyed themselves, but all staff agreed that it was not a good arrangement, and small group holidays will be arranged in future, with individual choices discussed. Suitable locks have been fitted to residents’ bedroom doors to provide for their privacy and security where necessary, except for one bedroom, which leads to a fire escape. The occupant of this room said that he had not had a problem, but others lock their rooms to prevent other residents entering. Residents can generally choose whether to be alone or in company, though some need constant supervision for health or other reasons. There has been a tradition of residents going to their room in the early evening for ‘quiet time’. This is not always popular, and residents may not be sent to their room against their will. Staff and management are seeking other ways of managing time and behaviour between activities. Breakfast is prepared individually, help given if needed by the staff member who had helped the resident with their personal care. Sandwiches are made for resident who will be out on activities, or snacks made at lunch time for whoever is in. The main meal is served in the early evening, with care staff taking turns. Residents were seen to be helping with preparation, under supervision, and enjoying this. Staff and residents were particularly pleased to be cooking vegetables they had grown at the Project. Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents with complex health needs are cared for consistently with attention to detail and changes in their condition. 18,19,20 EVIDENCE: The capability of residents with regard to their personal care and hygiene varies from needing total care to being entirely independent. Support is given as needed, and residents are encouraged to make choices as appropriate. Residents’ dietary and nutritional needs are considered. Some are trying to restrict intake of high calorie foods in the pursuit of weight loss. One has to ensure that he does not lose weight. He has been accompanied to meet with the dietician for advice. Food supplements are supplied. For residents who suffer epilepsy, a chart is kept of any seizures, and a record kept of what happened beforehand, which may have been a trigger. Records show that residents are regularly accompanied to appointments with specialists, for health checks and drug reviews, and there are records of multidisciplinary reviews. A Medical Action Plan is being written. Residents with complex health needs carry cards stating what action should be taken in the event of an emergency. Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 15 Parikia has a policy on the receipt, storage, administration and recording of medication. A list is displayed showing the names of staff who are trained and competent to administer medication. Security has been considered, and the key is kept where only these staff can get it. The Manager was aware of the danger of confusion with regard to one medication which could not be included in the monitored dosage system, and was considering a method to clarify the dose. No residents are considered capable of managing their own medication. A new fridge was obtained to keep insulin, in order that the correct temperature is maintained. A specific and comprehensive care plan is in place for the management of a resident with diabetes requiring insulin. The rota is checked to ensure that a staff member who is trained to administer insulin is available at the necessary time. There have been slight delays at weekends, when there has been an unexpected absence, and the Manager has been called in to fulfil this need. Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Allegations and other issues reported to the Manager had been dealt with thoroughly. 22,23 EVIDENCE: The complaints procedure is included in the Service Users’ Guide, and displayed in residents’ bedrooms. Complaints and the response made by the Manager are recorded. However, no visitors to the home who returned comment cards knew there was a complaint procedure. The home had received a complaint from a resident in December 2005, which resulted in an allegation of financial abuse being up-held. The Manager took appropriate action. An anonymous complaint was made to the CSCI in October 2006, concerning the safety of a resident, staffing levels in general, and the fears about the safety of the climbing wall that is being built. Because of the safety of the resident, including absconsions, management were consulting with health and social service professionals in trying to reach a satisfactory plan of action. Staffing levels are generally sufficient for the activities planned, but when there are problems with residents’ behaviour and emotional and psychological well being, the need for staff attention rises. The Manager increased staffing, to provide 1;1 attention for disturbed residents. However, this regulation was not fully met, as staff also said that absences were not always covered, leading to difficulties. The climbing wall is still in construction, and covered with a tarpaulin so that it is not accessible to residents. The Service Provider stated that appropriate health and safety clearance will be obtained, and a copy supplied to the CSCI. Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 17 Residents meetings often deal with residents’ complaints about each other. Parikia has a policy and procedure on the protection of vulnerable adults, but it needs to be up-dated in line with current practice, so that any member of staff referring to it will obtain accurate and useful advice. Staff have received training in the Protection of Vulnerable Adults (POVA). One of the Home owners also undertook this training. Some staff, plus the Registered Manager and one of the Home owners, have also undertaken training in Child Protection, as the home is registered to care for residents aged 16-17 years. Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The house is large and gives a good choice of places for different activities, but some maintenance issues are outstanding. 24,28,30 EVIDENCE: This house has a variety of spaces to enable residents to engage in activities that are social or practical. The lounge and dining room have been redecorated, and are looking bright and comfortable. The basement is usable, but has a slight smell of damp, and lacks a floor covering. The workshops have electric lighting, but no power, so that residents can work unsupervised without danger from power tools. One resident is often out in the workshop, mending bicycles. The garden is big enough for ball games and barbeques. A track has been built for residents’ remote control cars, and a climbing wall is being constructed. This large house with lively occupants needs constant maintenance, and a worker is employed full-time for this purpose. Work is on-going, but there was Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 19 not a written plan of improvements. One of the new Senior staff had just been given responsibility to oversee house maintenance. Wardrobes in need of repair were seen in two bedrooms. A general survey of curtain rails is needed, to provide types suitable to the occupant of each room. Parikia has large windows, and not all residents have ability to manage their curtains. One was seen to be missing, another was falling off, and one resident requested blinds because she is unable to draw her curtains. Cracks were seen in the enamel of two hand basins in residents’ bedrooms, the enamel in one upstairs bath was poor, and there was a hole in the other. The kitchen has sustained damage to the unit and floor around the sink, which is awaiting repair. The dining room has been decorated, and has a calm, light appearance. Furniture and seating arrangements are being reconsidered, with regard to their effect on social behaviour. There has sometimes been a problem with hot water not being available when residents wish to bathe. This large house has five hot water tanks, as it was once divided into five flats. Water may run out in the popular bathrooms, but be available elsewhere in the house. The washing machines also draw water from one of these systems. The Service Provider stated that he intends to install a separate water heater for the laundry, which will improve the situation. There is one electric shower which can supply instant hot water. It does not have a thermostatic control, so it has to be kept out of action unless staff are available to activate it and supervise any resident bathing there, to ensure they do not suffer scalding. Laundry bags have been introduced, to keep dirty clothes separate from clean clothes. Each resident has a washable draw-string bag in their room, to collect soiled items. Clean clothes are returned in a plastic box. Soluble bags are available for soiled clothes or bed linen. Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. While staff are competent and well motivated, and training is provided, there have not been sufficient staff on duty at all times to deal with residents’ needs and problems arising, and the recruitment procedure was not fully protecting residents. 32,33,34,35 EVIDENCE: All staff are designated Care Workers, some with additional responsibilities. A new team of Seniors had been appointed. They were keen to get organised and make a difference. They were planning to meet on Fridays, to ensure that plans for activities and staff are in place. One each had been given responsibility for medication, residents’ money, and oversight of house maintenance. Relationships between staff and residents have been seen to be very good. Staff had good communication skills, and a positive regard for the residents. There had been a recent change of staff, with people leaving for a variety of reasons, and recruitment taking place. Staff are continuing to work towards NVQ achievement at levels 2 or 3 as appropriate. The Manager is in the process of arranging LDAF training (Learning Disability Award Framework). Staff expressed concern that the routines at breakfast time did not always work as well as they should. Some residents rise early and need attention, Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 21 and had not always received it, as staff on duty had not acted promptly to prevent problems from arising. There has been a change recently as the staff member who was making breakfast has left, and staff had started to come down with the resident they had been helping, and get their breakfast. The Manager should discuss breakfast-time routines with staff and residents, to consider how to give the best start to each day. The Manager stated that he is prepared to provide cover when necessary, and has often done so. However, staff said that absences are not always covered, and this leads to problems. Half the visitors to the home who returned comment cards to the CSCI said that there are not always sufficient staff on duty. On the first day of this inspection a staff member was at a training session, which meant that the activity they normally provided was not available. The lack of alternative arrangements contributed to one resident’s disturbed behaviour. Files of three recently recruited staff members were examined. Parikia has a suitable procedure. All staff had completed application forms, attended interviews and met with residents before starting work, but not all files contained the two references and proof of identity that are required to ensure the safety of the residents. A newly recruited staff member was working a shadow shift during this inspection. POVA checks and CRB clearances are requested on behalf of all staff. One recently recruited Carer had been working night duties before the CRB clearance had been received, which is unacceptable as supervision is not possible. The Service Providers had produced new contracts for all staff, and were in the process of distributing them. The management team continue to provide and encourage training. Staff had benefited from training in Total Communication, drug administration, epilepsy, autism, health and safety and control of infection. Further sessions on Autism and Epilepsy were planned for the near future. The Manager is aware that underpinning training needs to be LDAF accredited, and has plans to provide for this. The Manager has records showing that he conducts individual supervision sessions with care staff. Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The management team are working to bring in their new ideas but have not yet developed all systems and procedures needed to establish a well run home. 37,39,42 EVIDENCE: The Registered Manager expects to complete NVQ4 in Care by the end of 2006, and will then continue with the required elements of the Registered Managers’ Award. He should enhance his training specific to the client group at Parikia. He needs to agree a job description with the new home owners, to set out his responsibilities to ensure that the aims of the home are met and that the home complies with the Care Standards Act and Regulations. The new home owners, Mark and Esther Brandwood, registered as Service Providers with CSCI on 11th August 2006. Mr Brandwood has experience of working with younger people with Learning Disabilities as woodwork and craft Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 23 tutor, and activities organiser. Mrs Brandwood has a Higher National Diploma in Business and Finance and an Honours Degree in Travel and Tourism. They are both fully involved with the work of the home. Mrs Brandwood has taken responsibility for administration. The period since their arrival has been difficult. Residents have had problems requiring specialist attention, and there has been a considerable turnover in staff. The management are building their new team, and offering enhanced pay for skills, aptitude and qualifications. They are trying to hold fortnightly staff meetings, and have included these in the rota, but not yet found an effective way of consulting with the staff as a group. There is not an effective quality assurance system in place yet. Good work had been done to gather feedback from residents and to encourage them to think about their preferences. Residents meeting have continued, on most Sunday evenings. Their views and aspirations need to be incorporated into the home’s annual plan. Audits of the home’s various systems should be recorded, to ensure that procedures are maintained satisfactorily. Fire alarms were tested weekly, and had been serviced on 03/05/06. On 26/10/06 the fire extinguishers were serviced and staff trained in their use. Two staff are trained as Fire Marshals, and the Manager was keeping a chart showing staffs’ fire training. Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 2 3 2 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 3 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 2 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 2 X X 3 X Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 25 Yes Are there any outstanding requirements from the last inspection? 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. 1 Standard YA30 Regulation 13(3) Requirement Timescale for action 31/01/07 2 YA33 18(1)a 3 YA34 17(2) 4 YA35 18(c)(i) ‘The Registered Person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home.’ - Baths and hand basins must have sound surfaces that are easily cleanable. 30/11/06 ‘The Registered person shall, having regard to… the needs of the service users…ensure that at all times…suitable persons are working in the care home in such numbers as are appropriate for the health and welfare of the residents.’ - Sufficient staff must always be employed to meet the needs of residents. ‘The Registered Person shall 30/11/06 maintain in the care home the records specified in Schedule 4.’ - Staff must not work unsupervised, which includes night duties, until a satisfactory CRB clearance and two written references are obtained. ‘The Registered Person shall 31/01/07 ensure that persons employed to work at the care home receive DS0000067447.V310886.R01.S.doc Version 5.2 Parikia APL Page 26 5 YA39 24 training appropriate to the work they are to perform.’ - Certified Learning Disability Award Framework training must be delivered. Previous time scale 12/12/05 An effective quality assurance 12/12/06 system must be introduced, to review the service in consultation with residents, and provide a copy of the report to the residents and to the CSCI. 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 Refer to Standard YA16 YA23 YA24 YA33 YA37 Good Practice Recommendations Ways of managing time between planned activities should be considered, and the tradition of ‘quiet time’ made optional. The Adult Protection policy and procedure should be revised, and a copy sent to the CSCI. Types of curtain rails should be provided that are suitable to the occupant of each bedroom. The Manager should consult staff and residents about early morning routines. The Registered Manager should have a job description which sets out his responsibilities. Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. Extracts may not be used or reproduced without the express permission of CSCI Parikia APL DS0000067447.V310886.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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