Inspection on 24/08/07 for Parikia Residential Care Home

This inspection was carried out on 24th August 2007.

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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Parikia Residential Care Home 10/10/06

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 Michelle Finniear Unannounced Inspection 24th August 2007 9:00 Parikia APL DS0000067447.V343707.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.V343707.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.V343707.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 parikia@onetel.net 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.V343707.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age range 16-45 years Date of last inspection 10th October 2006 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 is a garden and a car parking area. Parikia cares for up to 12 younger adults with a learning disability. This service is aimed at people who enjoy activities, who may need help with motivation, and who may wish to work towards independence. Staff sleep in at night. Fees range from £650 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.V343707.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is about some of the things that have happened at Parikia since the last inspection visit in October 2006. To help CSCI make decisions about what it is like to live at Parikia the owners and manager gave us information in writing about how the home is run; information sent to us since the last inspection was looked at, along with what we found when we last visited; a site visit of 8.5 hours was carried out without saying when we were coming; we talked to the manager and staff on duty during this visit ; with we looked at some of the records the manager keeps, such as medication records; and we looked at the house to see if it was clean and in a good condition. We also looked at the records kept about the people who live at the home and we looked at how well the home understands and meets their needs, and the opportunities and lifestyle they experience. Time was spent with some of the people who lived at the home, and some completed questionnaires about what it is like to live at Parikia. Other questionnaires were completed by their families with the help of the manager. This is so that we could get as many peoples views as possible about how the home is run. What the service does well: Parikia is a big house, where all the residents have their own room and other places to go if they want to be with other people or be on their own. There are lots of different things to do. Some residents enjoy going 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 days to talk about things. Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 6 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. What has improved since the last inspection? What they could do better: Personal information about people living at the home must be kept private. Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 7 The manager must ensure staffing levels are kept under review. This is so that people can do what they want to do with staff support. The manager must make sure that people are supported to look after their health. If people living at the home do things that upset or hurt other people then staff must all help them in the same way. All staff must have training in what to do if they think one of the staff may have done something that might harm a resident when they start to work at the home. A development plan must be provided, based on information gathered about what people think about the home, and the homes own assessments of what they do well and what can be improved. The manager must make sure the fire doors fit properly, so that everyone is safe if there is a fire.. The manager must look at the home and the way the staff work to make sure they are safe. Information for people at the home should be written in a way they can understand. The manager must make sure that people who live at the home who want to look after their own medication are safe and know how to do it right. The broken shower should be mended. The manager must make sure that polishes and things to clean the home are kept safe. 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.V343707.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.V343707.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): 1, 2, 3, 4, 5. Quality in this outcome area is good. People can receive information and can stay for a short visit to help them decide if Parikia is the right place for them before they decide to move in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: No new people have been admitted to the home since October 2006, however discussion was held with the owners and the manager concerning a person who is thinking about moving in. This person is having a series of trial visits once a week for seven weeks over the school summer holidays so that they get a good idea of what it is like to live at Parikia. The staff at the home have been given some information about the support this persons needs and they and their family have helped the home to complete an admission form which contains information about what they like to do. This helps the home make sure that they can offer the help the person needs. It also helps to make sure that the person will fit in with the other people already living at the home. When they are at Parikia this person is completing a diary to show their families and friends what they have been doing when at the home. Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 10 If they decide they wish to move into the home and the home feels they can meet their needs then a full care plan and contract will be prepared. Contracts contain information about peoples rights and what they can expect to receive for the fees they pay. The home has information available to let people thinking about coming to the home know what it is like to live at Parikia. This ‘service user guide’ has pictures of people carrying out activities and about the accommodation and services provided, as well as what to do if people think it may be the right place for them. The file for last person admitted to the home was seen, which showed how they had decided to live at the home. This included having a short stay to see if they liked it before making a final decision to move in. People who live at the home filled in questionnaires about being at Parikia. They said they had been asked if they wanted to move into the home and some had been there before for the day or on respite so they knew what it was like. Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 11 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): 6,7, 8, 9. 10. Quality in this outcome area is adequate. People living at Parikia have plans to identify the support they need and how they wish this to be given. People have a say in the way they spend their lives. Peoples privacy and dignity must be respected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person living at the home has a plan of care, which explains the support the person needs in their daily life ands how that support is to be given. The home is developing some new care plans which will contain more information about each person and how they wish their care to be delivered. A new style of plan (for someone who has now left the home ) was seen and three examples of the older style of plan were seen on the site visit. Care plans seen contained information about the people living at the home, and the care they needed. They also had some information on how people chose to spend their lives and on any risks that may cause. Risk assessments help to make sure that any risks are identified and managed, and might for Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 12 example include information on people using roads safely. Following recent assessments the home is not using the newly built climbing wall until further information on it’s compliance with standards on safety has been provided and risk assessments have been compiled for people who may wish to use it. People living at the home who were spoken to on the site visit said they made choices and decisions in their lives and some information on this could be seen in daily diaries and files. People who completed questionnaires also said they could do what they wanted to during the day and evening and that they always or sometimes made decisions about what they did each day. There are daily meetings to decide plans for the day and a pictorial chart was available for one person to demonstrate in a way they would understand how their day is to be spent. They can also then check this information when they wish during the day to re-assure themselves. Information is also available on a board to detail staff on duty and meals planned. There is a weekly meeting where chores such as table laying, cooking and washing up are allocated or ‘bidded for’ and people spoken to were clear about what their allocated chores were. The home has a system of checking each persons completion of tasks on a daily basis. People are scored on their achievements which are then charted. However this was seen to be conducted in way that did not support peoples privacy and dignity. Discussion was held on this with the owners and manager who agreed to re-examine the way this information is gathered and used. It was not clear that this system supported peoples independence and choice. Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 13 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): 12, 13, 15, 16, 17. Quality in this outcome area is good. Opportunities are available for people to lead full and active lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living at Parikia can lead a full and active life. The home in particular caters for young people with learning disabilities who wish to be active. The homes information states that “To provide the necessary leisure and exercise, our activity programme is a mix of recreational and sporting activities, social events and work related instruction.” People can also take part in social activities in the local area for example in local clubs and discos. People living at the home are involved in a local special needs football league and have opportunities to take part in workplace opportunities. Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 14 On the day of the site visit the people living at the home decided to go to the local beach crabbing and then have a picnic. This took place after chores had been done at the home for example cleaning of bedrooms. One person chose to stay behind at the home. People have opportunities to take a part in the life of the local community, and access both specialist services and also those for the wider community. People living at the home spoke about their participation in a special needs football league and also about some of the other things they are involved with individually or as a group. Some staff questionnaires returned indicated that staffing shortages impacted on the activities people were able to be involved with. The home management have stated that at no time do they fall below minimum supervision requirements for staffing, and that staff are regularly bought in to facilitate the activity programme. People living at the home are helped to maintain contacts with family and friends and one spoke about recent support they had needed with the illness of a relative. Within the home relationships were sometimes difficult but people have managed to find successful ways of dealing with their differences. Staff provide role models and work quite democratically with people living at the home. A staff member spoken to had a clear understanding of peoples rights and responsibilities in their daily lives, as well as the staff role in supporting and facilitating them. People who live at the home have some choices in the meals they receive. This also includes an involvement in the cooking of food. On the day of the visit this included making sandwiches for a packed lunch and cooking a barbeque in the evening. People have access to the kitchen to make snacks and hot drinks and have requested a ‘café bar’ area be built so that they can have full access to these facilities, even when meals are being prepared. The homes management are in discussion about this. Some concerns were expressed that food being bought is of a lower quality than previously, and discussions were held on the sit visit about how to ensure an appropriate balance between a healthy diet and peoples choices. The management denied that food was of a lower quality and stated that they have reduced the amount of tinned/frozen goods in favour of fresh produce.. People living at the home said it was a good place to live and that they felt “Like a family” which demonstrates a feeling of safety and companionship. Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 15 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): 18, 19, 20 Quality in this outcome area is adequate. People receive the support they need to manage their healthcare. Current systems are to be developed which will increase peoples involvement in making decisions on their own health. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living at the home have their healthcare needs identified in their care plans, three of which were seen, and people are consulted upon the development of their plans and how they wish their care to be delivered. Health action plans are due to be implemented in the near future, which help people look at goals with their health and have a greater involvement in their healthcare planning. Discussion was held on the way the home is increasing independence for people in some areas of their healthcare, for example taking more control of their own medication. Plans included protocols for example for the Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 16 administration of epilepsy medication, which makes sure that people know how to use emergency medication in a way that is appropriate for that person. One persons file included detail on emergency treatment needed, and this could be seen to be actioned during the day. This demonstrated that staff and management were aware of and acted upon the instructions of the medical consultant. People at the home are encouraged to lead physically active lives, with a variety of activities throughout the day. As a result of a recent review a dietician is to be involved in one persons care to ensure that they can maintain and hopefully increase their weight in a healthy way. Other people were trying to work on weight reduction. Information is available on particular health conditions which means that staff can gain a clear understanding of peoples needs and any potential complications or areas that need to be monitored. The homes arrangements for medication monitoring were seen on the site visit. The home uses a monitored dosage system, which means that medication is pre-packed in a series of blister packs by the supplying pharmacist. This makes it easier for staff to give out medication and to see if errors have been made. The home does not currently hold any controlled medication and discussion was held on how this could be managed if needed. Discussion was also held on the use of non-prescription or homely remedies, for which the home does not have a copy of the locally agreed list. At the time of the site visit two people were self administering some elements of their own medication, but a risk assessment has not been provided for this. Some protocols were in place for the management of behaviours that challenge, but these need to be increased for two other people living at the home to ensure staff are working consistently with the people living there. Some staff have training in breakaway and de-escalation techniques, but this is needed for some others. Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 17 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): 22, 23. Quality in this outcome area is adequate Arrangements are in place for the management of complaints and protection of people living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a policy and procedure for the management of complaints which was seen on the site visit. Three complaints have been received about the home since the last inspection which have been resolved by the home. One was also referred to CSCI and the local Adult protection services. This concerned a member of staff, and no further action has been taken. The home has a complaints book which was discussed. This book used to be used by people living at the home, but was being used inappropriately and so the home manager is considering implementing a new system for suggestions and concerns. The home also has an adult protection policy, copy of the local adult protection protocols and a whistle-blowing policy to enable people to alert appropriate agencies about issues of abuse. All staff with the exception of two have received training in adult protection. This helps to ensure staff are aware of what abuse is and what to do if they suspect it. Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 18 Information is available for staff on approved low level physical interventions for one person who may present behaviours that challenge or threaten others. This involves staff re-directing the persons attention to avoid a situation escalating into a major incident where the person may have to be contained physically for their own safety or the safety of others. In the next 12 months the home intends to prepare a policy on staff interaction during out of hours contact, and provide relationship training for people living at the home to ensure that they are capable of safely accessing the community independently and that they can maintain good relationships within the home. Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 19 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): 24, 25, 26, 27, 28, 29, 30 Quality in this outcome area is adequate. The home provides a comfortable environment for people to live and work in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Parikia provides a comfortable environment for people to live and work in. The home consists of a detached Victorian building, with sea views and gardens. Each person living at the home has a single bedroom, some of which are large, bright and airy. All of the bedrooms seen were very individual to the person living there. Cleaning and tidying of these rooms is done on a daily basis, and this is monitored by staff. There are several communal areas so people can be alone if they wish. There are also large gardens where a number of activities are being provided or developed, including a small race track for radio controlled cars and a climbing wall and assault course. Information supplied by the home indicates that residents are involved in gardening and recycling projects. Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 20 This information also states that the majority of rooms have been refurbished. Several areas seen on this inspection still required some attention. This included Fire doors, where in one particular instance identified to the management on duty there was a large gap between the end of the fire door in the floor. This could present risks in the event of a fire. There is a large patio to the rear of the home which during the day of the site visit was being used to eat lunch, and also for an evening barbecue. Discussion was held with the management on security railings to this area, and they confirmed that undergrowth has recently been cut back, which now presented a potential risk and that this would be addressed. The home also has a large grassed area in front of the home, and adequate parking. One person living at the home kept guinea pigs and rabbits in part of this area. The home is a no smoking area, however there is a designated smoking area to the back of the building with a safety ashtray for disposal. The home has a cleaner, and discussion was held on monitoring of cleanliness issues within the home. During the tour of the home some cleaning materials which should be kept locked away had been left out which could present a risk to people living at the home. Personal protective equipment such as gloves and aprons are available, and the home has a series of risk assessments available to identify and manage any risks within the environment. There is a laundry area to the rear of the building, and dispersible laundry bags are available to ensure that any soiled linen can be moved throughout the home without creating additional infection risk. Hand washing facilities and antibacterial soaps are available to ensure people can keep their hands clean. Baths and showers are provided throughout the building, with automatic water temperature regulation fitted according to the manager, to ensure that people cannot be accidentally scalded. One person living at the home commented that a shower close to their bedroom has a broken dial, and the manager agreed to ensure this was fixed in the last 12 months documentation supplied by the home indicates that they have refurbished the exterior and interior of the building, newly carpeted the living room and hallways, provided new sofas in the living room and chairs in the dining room, provided a barbecue area and new table and chairs outdoors, replaced the large minibus with three smaller vehicles, provided disabled toilets and a ramp, implemented a recycling project, provided the designated smoking area, climbing wall and car track. In the next 12 months they plan to complete the climbing wall, provide risk assessment and protocols for all new activities and equipment, repair and redecorate the garage doors at the rear of the building, redecorate the seller, re-designate and train new staff as health Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 21 and safety and fire officers, ensure risk assessments are reviewed and updated for all on-site projects, and complete a sensory area within the grounds. Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 22 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): 32, 34, 35 Quality in this outcome area is adequate. Staffing arrangements are satisfactory, however staffing levels may need to be examined to make sure that peoples needs are being met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion was held with the homes management concerning the recruitment practices at the home. Management could outline an appropriate recruitment system which included interviews and taking up of references. Three staff files were selected to include the most recent a member of staff appointed. Files contained evidence that the system was being followed through properly, and contained copies of references and criminal records bureau checks. These help to make sure that the people who are recruited are suitable to be working with vulnerable adults. The home has recently begun the learning disability award framework system for induction of care staff. Staff are to work through this as a group to ensure that everyone has the same understanding of heir roles and how they can provide good care in the same way. Information supplied by the home Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 23 indicates that they work to the General social care Councils code of practice, which is a structure for setting standards for conduct and behaviour of staff. A training matrix has been provided which identifies which training individual staff members have undertaken, and which needs to be provided or updated. This includes such areas as epilepsy, diabetes management, Aspergers syndrome and autism training as well us more general training such as health and safety, moving and handling, food hygiene, medication and fire prevention. Information from the management indicated that the majority of staff working at the home have also achieved National vocational qualifications, which are a national award reflecting the competency of staff in their work role. It is understood that the registered manager is an NVQ assessor. Supervision, which is a system combining performance management and personal development is being provided, but would benefit from development. Staff who completed questionnaires felt they did not always receive appropriate and supportive supervision, one commented there never seems enough time or enough staff to allow for supervision. The home has a system currently for supporting staff personal development, and systems for ensuring communication of information is delivered throughout the staff team. This for example includes daily handovers, staff meetings and a senior staff meeting held weekly. Information for people living at the home about staff coming on duty is available on the notice-board in the dining room. In the next 12 months the registered manager aims to complete his NVQ 4 in care, the home aims to complete the Induction framework training, training for fire and health and safety officers, and improve access to training. Discussion was held on the staffing arrangements at the home. There has been a significant number of staff leave since the last visit to the home, and additional staff are still being recruited. Many staff have however not been replaced as the number of people living at the home has decreased. Staff who completed questionnaires indicated that they felt the home was nearly always short staffed, and that this impacted seriously on the care that they could give. This was identified as an issue at the last inspection. The home management have stated that at no time do they fall below minimum supervision requirements for staffing, and that additional staff are regularly bought in to facilitate the activity programmes. On the occasion of this visit management staff came in through the day which meant that the home was appropriately resourced. People living at the home who completed questionnaires (some with the support of staff) indicated that the staff treated them well and listened and acted on what they had to say. Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 24 Staff spoken to on the site visit had a clear understanding of the needs of the people they were looking after, and one persons care in particular was discussed in detail and found to be an accurate reflection of their needs. Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 25 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): 37, 39, 42 Quality in this outcome area is adequate. The homes management systems are in development, but when completed will meet the needs of the people at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager of the home has achieved his Registered Managers Award, which is a qualification specifically related to the running of a care home. He is understood to be currently undertaking his NVQ level 4, which is in management level qualification and assessment of competency within the job role. Information supplied by the home before the inspection states that as the new service providers for Parekia they have spent their first year radically changing the way in which the home is run”. Policies and procedures have Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 26 been or are being updated. During the inspection site visit it was clear that a number of systems remain in development, but when completed should be of positive benefits to the home. People living in the home and who completed questionnaires generally seemed satisfied with the way that the home was run. Questionnaires returned from others expressed some concerns on what they saw was a decline of basic resources from staffing levels to food. They also felt the management structures were not best providing support for the manager or the clients at the home. Information supplied by the management of the home indicated that they have been working on changing the culture of the home, and that these concerns were not an accurate reflection of changes that have been made, which have been implemented to benefit people living at the home. The a new quality assurance systems is being developed and implemented. The system which is still in development includes a series of questionnaires for people living and working at the home to try to ensure that peoples views about the operation of the home are heard and that they have opportunities to influence the way care is delivered. Questionnaires for example include one regarding a persons admission and another on the staff induction processes, which will help the home ensure that what they wish to deliver is what people are experiencing. Discussion was held on aspects of health and safety at the home. Work was required to ensure the temperature of the water delivery to one shower was not too hot for peoples safety and the owner indicated that a full electrical survey has not been completed on the building since 1992, however regular checks have been done for new work and he was satisfied that the system was satisfactory. Portable appliance testing is being completed, and fire tests and drills were satisfactory, with yearly services and call points tested in rotation at each drill. The last fire test was on the fifth of August 2007. Staff receive training in health and safety, and a number of risk assessments were available, although others still need to be developed for safe working practices and the environment. Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 27 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 3 2 3 3 3 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 2 28 3 29 3 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 3 3 2 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 2 x 3 x 2 x x 2 x Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 28 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 YA10 Regulation 12 (4) Requirement Personal information about peoples day to day lives must be treated in a way that respects their privacy and dignity. The manager must monitor staffing levels regularly to ensure that peoples needs are being met. The manager must ensure that peoples healthcare needs are being addressed, through the use of health action plans and challenging behaviour plans, which help to ensure staff work consistently. All staff must receive training in Adult protection policies and procedures. An effective quality assurance 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. Previous date 12/12/06 The registered person must consult with the fire authority and ensure that all fire doors DS0000067447.V343707.R01.S.doc Timescale for action 25/08/07 2. YA33 18(1)a 25/09/07 3. YA18 12, 13 25/11/07 4. 5. YA23 YA39 13, 18. 24 25/11/07 25/11/07 6. YA24 23, 13 25/09/07 Parikia APL Version 5.2 Page 29 7. YA42 13 are fitting appropriately to ensure people are protected in the event of a fire. Risk assessments must be provided for safe working practices and the environment to make sure the home is a safe place to live and work in. 25/11/07 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. Refer to Standard YA20 YA27 YA30 Good Practice Recommendations Risk assessments should be provided for people who wish to self administer their medication. The shower with variable water temperature and broken dial should be repaired. Cleaning materials and chemicals must be kept locked away when not in use in accordance with the manufacturers instructions. Parikia APL DS0000067447.V343707.R01.S.doc Version 5.2 Page 30 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.V343707.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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