Inspection on 04/05/05 for Parkcare Homes (No 2) Ltd (Devonshire Road)

This inspection was carried out on 4th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Parkcare Homes (No 2) Ltd... 18/09/07

Parkcare Homes (No 2) Ltd... 05/04/06

Parkcare Homes (No 2) Ltd... 01/12/05

Parkcare Homes (No 2) Ltd... 11/01/05

Parkcare Homes (No 2) Ltd... 21/05/04

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

CARE HOME ADULTS 18-65 PARKCARE 43 DEVONSHIRE ROAD Palmers Green London N13 4QU Lead Inspector Jane Ray Announced 4 May 2005 at 09.30am 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 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 Stationary 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. PARKCARE 43 DEVONSHIRE ROAD Version 1.10 Page 3 SERVICE INFORMATION Name of service Parkcare 43 Devonshire Road Address 43 Devonshire Road, Palmers Green, London N13 4QU Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8882 4702 020 8882 4702 devonshire.road@craegmoor.co.uk Michael Byrne for Parkcare Homes Ltd Mr Brian Hughes PC Care Home only 6 Category(ies) of LD Learning Disability registration, with number of places PARKCARE 43 DEVONSHIRE ROAD Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 11 January 2005 Brief Description of the Service: Devonshire Road is a home for six young adults with a learning disability. The home was first registered in October 1991. Parkcare Homes Ltd, which is a subsidiary of Craegmoor Healthcare Limited, manages the home. Whilst the home is registered for six younger adults one of the bedrooms could be shared but currently is occupied by one resident. This means the capacity of the house at present is only five residents. At the time of the inspection there were four residents living in the house and a final resident moving in during the next few weeks. The home is a terraced house located a short walk from the shops at Palmers Green. There is one bedroom on the ground floor and four bedrooms on the first floor. There is a bathroom and separate shower room on the first floor. There is a small garden at the rear of the house. The staff team consists of a manager, deputy manager and team of care staff. During the day there are two or three staff on duty and at night there is one waking and one sleeping member of staff. The residents access local community facilities and the home has a people carrier vehicle to support these activities. PARKCARE 43 DEVONSHIRE ROAD Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over five hours and was the annual announced inspection. A tour of the premises took place and the staff and care records were inspected. The inspector met and spoke to all the residents although one resident was unfortunately unwell during the inspection. The inspector also met all of the staff who were on duty and they were very willing to discuss their work in the home. The registered manager assisted throughout the inspection. What the service does well: What has improved since the last inspection? Since the last inspection there have been some environmental improvements in the home including some decoration work and the repair of the carpet on the first floor landing. Health and safety training including food hygiene and first aid has taken place. Further training such as moving and handling has been arranged and the staff who need to receive the training have been given places. Training on mental health, which is relevant to the staff working at Devonshire Road has been planned and staff have been offered places. Six staff have started NVQ training and when this is complete there will be more than 50 of the staff team with this qualification. PARKCARE 43 DEVONSHIRE ROAD Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. PARKCARE 43 DEVONSHIRE ROAD Version 1.10 Page 7 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 Standards Statutory Requirements Identified During the Inspection PARKCARE 43 DEVONSHIRE ROAD Version 1.10 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3,4 and 5 The admissions process is working well and prospective residents are introduced in an appropriate manner to the home where they can be confident that their needs can be met. These standards were met. EVIDENCE: Two of the residents explained that a new resident will be moving into the home. They said that she had been invited for an evening meal and a weekend stay and this had gone very well. The existing residents had been asked if they were happy that this new resident would fit in to the home. The four resident case notes all contained copies of the completed contract between the home and the resident. This was in a format that was clear and easy to understand and had been signed by the resident. The staff were observed during the inspection supporting the residents and all appeared to have a good understanding of their individual needs. This was also reflected in the comments during the inspection from the residents who all said they were satisfied with the standard of care. One resident may be developing dementia and training has been arranged to support the staff to understand and appropriately meet his needs. PARKCARE 43 DEVONSHIRE ROAD Version 1.10 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8 and 9 These standards were partly met as the assessments, care plans and risk assessments were in place and there was evidence that where possible these had been agreed in consultation with the residents. The care plan for one resident needs to be updated to reflect changing care needs. EVIDENCE: The four service user case notes were inspected and they all included up to date assessments and care plans that are being reviewed on a monthly basis. Each resident also has individual risk assessments. It was noted that one resident has changing needs and this must be reflected in his care plan. Each resident has a key worker. There was a record of each resident having their care plan reviewed at a meeting with their care manager in the previous year. Where the resident had complex behaviours there were guidelines in place about how they should be supported with these individual needs. PARKCARE 43 DEVONSHIRE ROAD Version 1.10 Page 10 The residents were able to explain that they are able to make decisions and choices about their daily lives in the home. This includes making choices about what they want to eat, what activities they want to enjoy and when they want to spend time on their own or with others in the lounge. PARKCARE 43 DEVONSHIRE ROAD Version 1.10 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16 and 17 These standards are partly met as the residents are supported to develop individual skills within the home but still need additional support to broaden the activities they participate in within the community. EVIDENCE: The inspector spoke at length to the residents and the staff. The residents were able to describe how they are supported to help with domestic activities including cleaning their bedrooms, doing the laundry and preparing snacks and drinks. The staff also explained how the residents who have higher support needs are also being encouraged to increase their skills and one service user for example is being supported to gradually use more words to develop his communication. One resident who could attend college explained that she does not wish to go at present and prefers to spend her time developing her domestic skills and accessing local community facilities. PARKCARE 43 DEVONSHIRE ROAD Version 1.10 Page 12 The record of activities were inspected for all the residents over the previous month. One resident had a record of regular activities, one has health issues that affects his ability to go out. The manager said that he thought the activities for one resident had not been fully recorded. Two residents could be supported to participate in a wider range of activities based on their individual needs. The residents were able to show the inspector photos of previous holidays and days out. A summer holiday at Butlins has been planned. The staff were observed knocking on the residents bedroom doors before entering their rooms. They were also seen chatting with the residents throughout the inspection. The residents were able to say how well they got on with the staff and that they enjoy a “good laugh”. The inspector enjoyed a very healthy and well presented lunch with the residents. The record of food consumed showed that the meals are healthy and nutritious. The residents and staff were able to say how they choose the meals and they shop for fresh produce at the local supermarket. During the lunch one resident needed some staff support to eat his meal and the staff were observed feeding him too quickly with too much food on the spoon. Staff need to be reminded to support the residents with eating in a slow and careful manner. PARKCARE 43 DEVONSHIRE ROAD Version 1.10 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 and 21 These standards were almost met as the residents were supported to access the necessary healthcare appointments and personal support although where a resident refuses to attend appointments then risk assessments need to be completed to address this issue. EVIDENCE: It was observed during the inspection that service users were supported with their personal care if required. This was observed to be delivered in a private and appropriate manner. The residents were able to talk about how they have their hair done and shop for new clothes. One resident is experiencing a reduction in his mobility. He has been supported to be referred to receive a wheelchair to meet his individual needs. The record of healthcare appointments for each resident was inspected. These showed that they were being supported to receive their individual healthcare checks. Two of the residents refuse optical checks and this needs to be recorded with appropriate risk assessments. It was positive to note that where there are concerns about a residents healthcare needs that this is addressed in a prompt manner and specialist input is sought as appropriate. During the inspection one resident was unwell and had to be admitted to hospital. This was handled in an calm and professional manner. PARKCARE 43 DEVONSHIRE ROAD Version 1.10 Page 14 The medication and administration records were inspected and were satisfactory. The manager explained that five staff administer medication and their training records showed they had all received medication training. The four service user case notes were inspected. These all include a record of the wishes of the service users or relatives in the event of the death of the service user. PARKCARE 43 DEVONSHIRE ROAD Version 1.10 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 These standards were partly met as some staff have not yet received training on adult protection and supporting service users who have aggressive behaviour, but this training has been booked. There is however still a need to have an accurate record for each service user of how they are supported to manage their personal finances. EVIDENCE: The record of complaints was inspected and there have been no complaints since the previous inspection. Nine staff still need to complete adult protection training and this has been booked in three separate sessions over the next three months. Nine staff still need to complete training on how to support service users who have challenging behaviours and this has been booked in three separate sessions over the next three months. The residents case notes were inspected and the record of how they are supported with managing their personal finances was not clearly recorded stating who assists them to claim their DSS benefits, where this money is held and how the resident can access the money. PARKCARE 43 DEVONSHIRE ROAD Version 1.10 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29 and 30 These standards were met as the environment was clean, comfortable, well maintained and homely. EVIDENCE: The home is a terraced house and is in keeping with the surrounding premises. The building is clean and well maintained. The home provides access to local amenities including shops, parks and public transport. Each resident has a single bedroom and these were appropriately furnished. There is a bathroom and separate shower room on the first floor. There is a small lounge, dining room and kitchen on the ground floor that are all appropriately furnished. The washing machine is located in a small utility room on the ground floor. The house has a small enclosed garden at the rear and this can be accessed through the office. The garden has a table and chairs so the residents can sit outside. PARKCARE 43 DEVONSHIRE ROAD Version 1.10 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,34,35 and 36 The standards are partly met as the home does have a stable and effective staff team but there still needs to be work to ensure that staff have all the necessary recruitment documentation. EVIDENCE: The staff rota was inspected. The staff team is very stable and there are adequate numbers of staff working in the home to meet the needs of the residents. Six staff files were inspected including one member of staff who has been recruited since the previous inspection. All the staff had a Criminal Record Bureau check and two written references. They also all had a copy of their terms and conditions. One member of staff did not have a copy of her passport in her file and some staff did not have a record of authorisation to remain and work in the country where appropriate. The record of staff team meetings was inspected and these are taking place every two months. PARKCARE 43 DEVONSHIRE ROAD Version 1.10 Page 18 Each member of staff has an individual staff training record and there is an ongoing programme of staff training. The staff training records showed that the staff had completed their induction training. The manager explained that he has completed the NVQ level 4 and the deputy has started the NVQ 4, two staff are undertaking NVQ3 and two staff are undertaking NVQ 2. The assessor comes to meet the candidates at the home. Training has been arranged to support the staff to meet the specific needs of the residents including training on dementia, epilepsy and mental health. The staff supervision records were inspected and staff are receiving regular supervisions and regular appraisals. PARKCARE 43 DEVONSHIRE ROAD Version 1.10 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,42 and 43 The standards are partly met as the home is well managed and appropriate health and safety measures are in place but the quality assurance audit needs to be completed. EVIDENCE: The home has a permanent registered manager who has the appropriate skills and experience and provides professional leadership to the service. The quality assurance system needs to be fully implemented. Questionnaires need to be sent to service users, relatives and other care professionals. Once responses have been received these need to be collated to prepare an action plan. The staff training records were inspected and all the staff had received training on fire safety, food hygiene and first aid. Five staff need to receive moving and handling training and these training dates are booked. Two staff need to PARKCARE 43 DEVONSHIRE ROAD Version 1.10 Page 20 receive fire safety training and company training packs are available on this topic. The inspector recommended that this training might benefit from being supplemented by a training video. The necessary certificates were available to confirm the gas system, electrical system and appliances, water system and fire appliances had been serviced. The record of smoke detector checks and fire drills indicated that these were taking place as required. The insurance certificate was inspected and is satisfactory. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 24 25 26 Version 1.10 Score 3 3 3 Page 21 PARKCARE 43 DEVONSHIRE ROAD Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 x Score 27 28 29 30 STAFFING 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 2 3 3 3 2 Standard No 31 32 33 34 35 36 Score x 3 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 2 x x 3 3 PARKCARE 43 DEVONSHIRE ROAD Version 1.10 Page 22 NO 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 6 Regulation 15 Requirement The care plan of one service user whose needs have changed must be amended to reflect these changing needs, The residents must be supported to access a wider range of community based activities on a regular basis linked to their individual needs and preferences. The staff must be reminded that when they support the residents to eat this must be carried out in a slow and careful manner with appropriate amounts of food available on the spoon. Where a resident refuses to attend a healthcare check an appropriate risk assessment must be completed. An accurate record must be completed for each resident giving details of how they are supported to manager their personal finances. This must include who assists them to claim their DSS benefit, where this money is held and how the resident can access the money. Each of the staff files must contain a copy of their passport. Version 1.10 Timescale for action 31/5/05 2. 13 16 15/6/05 3. 17 12 31/5/05 4. 19 12 31/5/05 5. 23 13 15/6/05 6. 34 17 31/5/05 PARKCARE 43 DEVONSHIRE ROAD Page 23 7. 34 19 8. 39 24 Where appropriate the staff file 15/6/05 must contain a record that they have authorisation to remain and work in the country. The quality assurance audit must 31/7/05 be completed and questionnaires sent to service users, relatives and other care professionals and the responses collated to prepare an action plan. 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. Refer to Standard 42 Good Practice Recommendations Fire training videos should be obtained to provide a visual aid for the fire safety training. PARKCARE 43 DEVONSHIRE ROAD Version 1.10 Page 24 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate London N14 6HA National Enquiry Line: 0845 015 0120 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 PARKCARE 43 DEVONSHIRE ROAD Version 1.10 Page 25 - 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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