Inspection on 16/05/05 for Parklands

This inspection was carried out on 16th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Parklands 21/08/09

Parklands 22/08/06

Parklands 03/02/06

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Parklands 7 Eldersley Close Redhill Surrey RH1 2AJ Lead Inspector Pat Collins Unannounced 16 May 2005 10.00 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. Parklands H58-H09 s61565 Parklands v227560 160505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Parklands Address 7 Eldersley Close Redhill Surrey RH1 2AJ 01737 765179 01737 765179 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) Mrs Mary Frances Philpot Mr John W. Musana Care Home 4 Category(ies) of LD Learning Disability 29 years - 55 years (4) registration, with number of places Parklands H58-H09 s61565 Parklands v227560 160505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age range will be younger adults with Learning Disability (LD) between 29-55 years of age excluding Physical Disability (PD) and Mental Disorder (MD). 2. The manager to complete Level 4 NVQ Management by June 2005. 3. The manager to attend protection of vulnerable adults training by June 2005. Date of last inspection None Brief Description of the Service: Parklands is a newly registered care home offering accommodation and personal care for four adults with learning disabilities of either gender, aged between 29 and 55 years. Service provision may include mildly challenging behaviours, autistic spectrum disorders and epilepsy. Parklands is a modern bungalow situated in a quiet residential area yet within walking distance of Redhill town and its wide range of shopping and leisure facilities. The accommodation is domestic in scale and character, affording all single bedroom accommodation. Two bedrooms share an ensuite toilet and shower and there is a bathroom, kitchen, utility area and combined lounge and dining room. The home has a secure and private garden. The philosophy of care aims to ensure an enabling environment which maximises abilities and independence and provides a person centred approach to meeting needs and individual aspirations. Parklands H58-H09 s61565 Parklands v227560 160505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out in two parts over two and half hours on the same day. This was in order to flexibly accommodate a pre-arranged activity outside of the home involving the manager and one of the residents. This left the home unoccupied for a period of time. The manager was not present during the second half of the inspection that formed the majority of the time the inspector spent at the home. The inspection process included feedback from the two residents currently living at Parklands and from relatives. Also direct observation of standards of care practice, a tour of the premises and examination of records. What the service does well: What has improved since the last inspection? This was the first inspection of the home since registration so it was not possible to see where improvements had been made. It was evident that the importance of advocacy and establishing and listening to the views of family members was recognised in the management and operation of the home. Relationships with Care Management and other agencies had been established. Arrangement for temporary use of a vacant bedroom for office equipment ensured residents’ living space was not inappropriately used as an office facility. Parklands H58-H09 s61565 Parklands v227560 160505 Stage 4.doc Version 1.30 Page 6 What they could do better: 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. Parklands H58-H09 s61565 Parklands v227560 160505 Stage 4.doc Version 1.30 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 Parklands H58-H09 s61565 Parklands v227560 160505 Stage 4.doc Version 1.30 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) 1,2,3 and 4 Residents had access to sufficient information including an accessible service users guide. They had opportunity for trial visits to the home to enable an informed choice on moving in. Admissions were on the basis of a full assessment of needs and risks. EVIDENCE: Information for prospective residents about the home had been produced in a format designed to ensure accessibility to people for whom the home was intended. The home’s statement of purpose and service users guide was in a binder in the office and accessible to residents. The home had two female residents and the admission procedures had been based on a full assessment of needs carried out by Care Management. There was also an assessment by the home to ensure needs could be met. It was not evident that individual preliminary care plans had been developed with prospective residents by the home based on care plans agreed with them produced by Care Management. Though both placements were at an early stage there were indicators that the needs and aspirations of current residents were being explored and effort made to meet them. The relatives of one resident informed the inspector that staff were exploring various educational and leisure opportunities to meet her needs and aspirations. Her family was also looking into a supported employment Parklands H58-H09 s61565 Parklands v227560 160505 Stage 4.doc Version 1.30 Page 9 opportunity. Staff were observed to be encouraging healthy lifestyles for service users in accordance with their assessed needs and wishes. They offered suggestions for healthy eating and promoted opportunities for exercising at local leisure centres. Parklands H58-H09 s61565 Parklands v227560 160505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 and 9. Needs and risks were not set out in a current care plan developed by the home in consultation with residents. The staff member in charge of the home however demonstrated knowledge of the needs of both residents and of risks. Staff respected residents rights to make decisions and for responsible risk taking in their daily lives. Residents contributed to the day-to-day running of their home. EVIDENCE: The service ethos was based on the premise that residents should be enabled to take control of their lives with the necessary level of support to promote individual independence. Risk assessments had been carried out for one resident in relation to going out alone in the community and other activities of daily living. A number of risk assessments and behaviour management guidelines for a resident had been helpfully compiled by a family representative. The need to review other risk assessments and management guidelines passed on for this individual from a former placement was advised to ensure their relevance to this new care environment. Risks and needs must be addressed by individual care plans and where necessary behaviour management guidelines drawn up in consultation with residents. Parklands H58-H09 s61565 Parklands v227560 160505 Stage 4.doc Version 1.30 Page 11 On the evening of the inspection residents were engaging in domestic routines in the running of their home. One person vacuumed the carpet and the other set the table. Both were consulted on their choice of food and one resident was involved in preparing the evening meal under staff supervision. One resident stated she prepared her own breakfast and packed lunch every day before making her own way to a social education centre. She described feeling supported by staff and working towards even greater independence. The other resident had gone shopping for food with staff on the day of the inspection after enjoying a horse riding session. Parklands H58-H09 s61565 Parklands v227560 160505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15, 16 and 17. Service provision was appropriate to enable residents to live fulfilling lifestyles in and outside of the home. EVIDENCE: Feedback from the relatives of one of the residents confirmed staff were exploring local opportunities for her participation in local educational and leisure activities in the community. Also opportunities for supported work experience on a community farm. For the other service user the importance of maintaining continuity of activities engaged in prior to admission had been taken into account to ensure individual wellbeing. This resident attended a social club every two weeks and various social events and discos arranged by her social education centre. The manager was perceived to have established positive relationships with individual family representatives to the benefit of residents. Residents informed the inspector of regular use of leisure facilities and enjoyed swimming and shopping. They were looking forward to holidays with their families later in the year. Daily routines promoted respect for residents private space and one Parklands H58-H09 s61565 Parklands v227560 160505 Stage 4.doc Version 1.30 Page 13 resident had a key to her room. A key was also available for the other resident if required. The staff member on duty was observed to interact regularly with both residents in an age appropriate, informal manner that created a friendly happy atmosphere. Residents were involved in decisions about the content of the evening meal and had agreed a rota for supported involvement in food preparation and setting and clearing the dining table. Parklands H58-H09 s61565 Parklands v227560 160505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 19. Service provision ensured appropriate personal and healthcare for residents. EVIDENCE: Based on information taken from records and feedback from residents and the staff member on duty, it was considered that personal support was provided with respect for residents preferences and knowledge of their needs. Residents described having control over the time they went to bed and when they got up dependent on planned activities. Though personal and health care needs were not addressed in a cohesive care plan as required, it was evident that staff were aware of needs and worked in partnership with advocates/ family members and professionals. Risk assessments required updating however for one resident to ensure their relevance to this particular home environment. The home’s records confirmed that residents were registered with a General Practitioner. Records indicated that resident’s health was monitored. It was noted that one resident had visited an optician since admission. Arrangements for dental care was not established on this occasion. Parklands H58-H09 s61565 Parklands v227560 160505 Stage 4.doc Version 1.30 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) 23 Residents were protected from abuse, neglect and self-harm through staff recruitment and vetting procedures. Staff must have updated adult protection training and be familiar with multi-agency adult protection procedures. EVIDENCE: To ensure practice safeguards residents and there is a robust response to suspicions or evidence of abuse the staff training programme must include recent adult protection training for all staff. Additionally, the home must have a revised copy of local multi-agency vulnerable adult protection procedures and ensure staff are familiar with the same. Evidence was found to substantiate that staff recruitment procedures included obtaining Disclosures from the Criminal Records Bureau. Parklands H58-H09 s61565 Parklands v227560 160505 Stage 4.doc Version 1.30 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 The physical environment was suitable to meet the stated purpose of the home. EVIDENCE: The home was clean and comfortable and met the requirements of the local fire service and environmental health department. Bedrooms were adequately spacious and were personalised, reflecting residents taste and choices. Wash hand basins were provided in bedrooms with the exception of one in which this had been removed to meet individual needs. A resident informed the inspector that the shower thermostat required repair. The staff member stated management were informed of this. The provider’s comments refer to the shower having been repaired at the time of the inspection. Residents stated they were both very happy with their new home. Parklands H58-H09 s61565 Parklands v227560 160505 Stage 4.doc Version 1.30 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) 33 The staff list demonstrated adequate numbers of staff to support residents needs. EVIDENCE: The staff list and staff rota was examined. Seven support workers were employed in the home in addition to the registered manager. Usual staffing levels were one on each shift though on some shifts two staff were on duty. The staff member on duty confirmed that one staff on duty was currently adequate to meet the needs and preferences of residents. This did not adversely impact on opportunities for choice for the residents currently accommodated. They both enjoyed going out together with staff. Parklands H58-H09 s61565 Parklands v227560 160505 Stage 4.doc Version 1.30 Page 18 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) 39, 40, 41 and 42 Though there had been work carried out on a quality monitoring system it was not evident that the provider conducted quality monitoring visits in accordance with statutory requirement. Further work was required on developing the home’s policies and procedures and in relation to record keeping practices. Further attention was also required on the home’s risk assessments. EVIDENCE: Quality monitoring systems were not evident from the records accessible at the time of the inspection. A user friendly format for consulting residents and seeking their opinion had been developed but it was not established that it had been implemented. It was acknowledged that the residents are both at a very early stage of their placement. It was not evident that the provider was undertaking unannounced monthly visits in accordance with statutory requirements and furnishing the manager and Commission with a written report of her findings. Policies and procedures required further development in consultation with residents and staff. Record Parklands H58-H09 s61565 Parklands v227560 160505 Stage 4.doc Version 1.30 Page 19 keeping must include a record of food consumed by residents in sufficient detail to be able to assess the adequacy of meals provided to meet dietary needs. The need to have a recent photograph on the files of both service users was identified. Parklands H58-H09 s61565 Parklands v227560 160505 Stage 4.doc Version 1.30 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 2 3 3 x Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 1 1 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Parklands Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x 2 1 1 1 x H58-H09 s61565 Parklands v227560 160505 Stage 4.doc Version 1.30 Page 21 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 OP 2, 6, 7, 8, 19, 41 Regulation 12(1)(a)( b), 13(7), 15(1)(2) Requirement For the home to develop with each prospective resident an individual plan of care based on care managements and the homes needs assessments and Care Managers care plans. The care plan can then be built on and must set out details of how risks and behaviours will be managed and needs and goals met. Care plans must be reviewed at least six monthly and any limitations on residents rights agreed with them must clearly recorded and regularly reviewed. For the home to ensure staff receive updated adult protection training and to have a copy and be familiar with the revised local multi-agency adult protection procedures. For the provider to undertake statutory monthly visits in accordance with the Care Homes Regulations and provide a copy of the report of those visits to the manager and the Commssion. For the policies and procedures to be developed covering the Timescale for action 30/05/05 2. OP 23, 35 13(6) 18(1)(a) (c) 16/07/05 3. OP 39 26(1)(4) (5) 16/06/05 4. OP 40 12(1)(a) (b) 16/08/05 Page 22 Parklands H58-H09 s61565 Parklands v227560 160505 Stage 4.doc Version 1.30 5. 6. OP 41 OP 42 17(1)(a) Sch 3.13 13(4), 17(1)(a) Sch 3.14, 23(1)(a), 23(4) 17(1)(a) Sch 3.12 7. OP 42 topics set out in Appendix 3 of the National Minimum Standards for Adults 18-65 years and Adult Placements. For records of meals to be maintained. To ensure the home has a health and safety and fire risk assessment in place and for all staff to receive fire safety training and to practice the homes fire procedures. For staff to be informed of the location of accident records to ensure these are completed at the time of witnessing any accidents. 16/06/05 30/05/05 30/05/05 8. 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 1, 22 Good Practice Recommendations For the homes complaint procedure to be produced in a format more accessible to residents. Parklands H58-H09 s61565 Parklands v227560 160505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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. 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