Inspection on 08/11/06 for Parklands

This inspection was carried out on 8th November 2006.

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

Parklands 30/03/09

Parklands 27/03/08

Parklands 29/11/05

Parklands 08/06/05

Parklands 22/12/04

Parklands 22/06/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Parklands Kensham Avenue Bradninch Exeter Devon EX5 4RD Lead Inspector Sue Dewis Key Unannounced Inspection 8 November 2006 10:15 X10015.doc Version 1.40 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 Parklands DS0000022003.V309024.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 Older People. 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. Parklands DS0000022003.V309024.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parklands Address Kensham Avenue Bradninch Exeter Devon EX5 4RD 01392 881375 01392 881375 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) Mr Roy Baker Mrs Heather Baker Care Home 27 Category(ies) of Dementia - over 65 years of age (27), Old age, registration, with number not falling within any other category (27) of places Parklands DS0000022003.V309024.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th November 2005 Brief Description of the Service: Parklands is a large detached, adapted home, that is former Duchy property. It tands in beautiful grounds with lovely views over the surrounding countryside. The home is registered to provide accommodation and personal care for up to 27 older people who may also have dementia. There are ten rooms within the home that are registered for double occupancy. However, all bedrooms are currently used for single occupancy only. Eleven bedrooms have en-suite facilities. There is a passenger lift to the first floor and ramps fitted around the home to give easy access for wheelchair users. An extension has been built to the side of the home and contains 7 bedrooms and a shower room. All new bedrooms are over 12 square metres with en-suite facilities. CSCI inspection reports are displayed on the hall table. Fees for the home are £400 per week. Parklands DS0000022003.V309024.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 7.5 hours on one day at the beginning of November 2006. The home had been notified that an inspection would take place within three months and had returned a pre-inspection questionnaire, information from which was used to write this report. During the inspection 3 residents were case tracked. This involves the inspector looking at the residents’ individual plans of care, and speaking with the resident and staff who care for them. This enables the Commission to better understand the experience of residents living at the home. Prior to the inspection comment cards were sent out to 10 residents and their relatives, 10 care workers, 4 GPs and the local social services team. At the time of writing the report replies had been received from all the residents, 9 relatives, 3 GPs and all the staff. During the inspection the inspector spoke with 3 residents individually and three in a group, as well as observing staff and residents during lunch time and late afternoon. The inspector also spoke with 2 staff and the management team. A partial tour of the building was made and a sample of records was looked at, including care plans, the fire log book and staff files. What the service does well: The home is well managed and provides residents with a safe, homely and comfortable place in which to live. The environment is good and staff and residents were all very happy with the care being provided. Care plans are good and provide staff with information on meeting the needs of the residents. There was some good practice observed and individual attention given to residents. Visitors are welcomed into the home and there are activities and entertainments available. Residents are able to personalise their own rooms by bringing items of furniture etc. into the home, and several rooms reflected the personality of the occupants. Staff were aware of what to do if they saw a resident being treated badly. Parklands DS0000022003.V309024.R01.S.doc Version 5.2 Page 6 Comments from residents, relatives and the District Nurse were all positive and included phrases such as ‘I cannot fault the care and attention I am given’, ‘all the staff are helpful and approachable’, the home is ‘very fresh and clean and comfortable’ and the food is ‘very good and appetising and well presented’. All care staff have now completed NVQ 2. What has improved since the last inspection? 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 DS0000022003.V309024.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Parklands DS0000022003.V309024.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are encouraged to visit the home and an assessment of the support they require ensures that the home can appropriately meet their care needs. The home does not provide intermediate care. EVIDENCE: The files of three residents were looked at, including that of the most recently admitted resident. All files contained detailed information on the needs of the residents and preadmission assessment forms were seen on the files of two of the most recently admitted residents. Parklands DS0000022003.V309024.R01.S.doc Version 5.2 Page 9 All three residents were spoken with, two could not remember if they had visited the home, but felt that their relatives would have made sure the home was right for them. The third resident, definitely had not visited the home prior to their admission, but had lived at the home for many years and had had their needs met appropriately throughout this time. The home does not provide intermediate care. Parklands DS0000022003.V309024.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are well formulated and give clear information to enable staff to meet resident’s health and social care needs. Care needs are well met in an individual manner by caring and informed staff and residents are treated with dignity and respect. The health care needs of residents are well met with evidence of good multidisciplinary working taking place where necessary. To ensure the safety of residents, all medicines are stored securely and generally administered appropriately. EVIDENCE: Care plans are produced from the assessments made before admission and adjusted as residents’ needs change. Three care plans were inspected. Each Parklands DS0000022003.V309024.R01.S.doc Version 5.2 Page 11 care plan set out in detail how the staff are to meet the day to day needs of the resident, and had been reviewed on a regular basis. Daily recordings are now made much more objectively and the information is useful and specific. Staff said that they found the care plans useful and the care manager said that the current system worked well to enable everyone to be involved in the maintenance of the care plans. Records were maintained showing visits by District Nurses and GP’s. The inspector spoke with a District Nurse who visited the home regularly. She said that she always found the staff helpful and that if staff request a visit she knows she is needed, as they are very good at assessing the risk to the resident. She said that she is very happy with the care given by staff and knows that they will follow any instructions she gives. Daily recordings are made by all staff and those seen on the care plans were useful and objective. Staff said that they found care plans very useful in helping them meet the needs of the residents. Staff were seen giving residents’ their lunch time medication, and correct procedures were generally followed. However, all medication was given before any recordings were made. Records should be signed after each individual resident has received their medicine. Comments were made by a GP that there had been ‘one episode in last 12 months of omission of medication. Resolved appropriately. Action taken to avoid reoccurrence’. There is a separate medicine room, where all medicines are securely stored. Two systems are in operation, one where medicines come from Boots and one from the local dispensing doctor. The home continues to follow the procedures for both systems that were recommended by the pharmacist inspector from CSCI at his visit on 16 July 2004. The inspector spent time in the main lounge observing the interactions between staff and residents. The inspector spoke with a group of three residents during this time. The lounge was very quiet, though residents were chatting between themselves and with staff when they brought a drink for residents. One resident told the inspector that the staff were ‘really helpful’ and gave her very good care, all residents said that staff were very respectful towards their privacy and dignity. One relative commented on their questionnaire that ‘the overall care given to my mother is of an excellent standard and I feel we were very lucky to be able to get my mother into this care home’. A member of staff commented on their questionnaire that ‘I think the standard of care at Parklands is excellent. Choices are always given and privacy is respected.’ Parklands DS0000022003.V309024.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Links with visitors and the community are good, giving opportunities to support and enrich residents’ social life. The home could improve the range of activities and entertainments on offer in order to further stimulate and occupy residents. Meals were seen to be well presented, providing nutritious variety and choice for residents. EVIDENCE: There are a variety of activities on offer, including armchair exercises, reading and jigsaws. The local band often visits the home to play for residents, who told the inspector how much they enjoy this. Staff said that they have time to sit and chat to residents, and residents confirmed this. However, two residents did say that they would like a few more activities. Staff told the inspector that Parklands DS0000022003.V309024.R01.S.doc Version 5.2 Page 13 residents had already told them that they wanted more activities and they were working on this. There is a sign near the front door saying that all visitors are welcome, but are asked to avoid meal times. Residents said that their visitors are always made to feel very welcome and visit often. One relative was spoken with and they confirmed that they were always made welcome and that they were able to take their relative out as often as they wanted to go. Residents told the inspector that they were able to spend their time as they pleased. They also said that they were able to get up and go to bed when the wanted to, and to sit either in the lounge or their bedroom. Lunch was taken with residents and it was well presented and nutritious. All residents enjoyed their meal and one commented that they liked everything that was given to them. Everyone was very complimentary and said that they always enjoyed the food. The relative that was spoken with also said that their relative told them they were very happy with the food. Parklands DS0000022003.V309024.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff, relatives and residents feel that any complaints would be dealt with appropriately. Residents are protected by staff that are able to recognise abuse and know their duty to report poor practice. EVIDENCE: There is a simple complaints procedure contained in the resident’s ‘Terms and Conditions’, and displayed on the notice-boards. Residents were able to say who they would talk to if they had any concerns, and felt confident that if they did they would be dealt with immediately. No complaints have been received by CSCI, since the last key inspection. Certificates were seen that showed staff have received training in recognising and dealing with abuse. Staff were able to describe a variety of differing kinds of abuse, including giving a resident their medication covertly if they had refused to take it. They were also able to describe the correct procedure of reporting any abuse that was suspected. Parklands DS0000022003.V309024.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides residents with a clean, safe, comfortable and homely place to live. EVIDENCE: The inspector looked at the communal areas of the home, and three individual residents’ bedrooms. The communal areas are safe and homely, with many ornaments and pictures around the home. They are decorated and furnished in a comfortable manner that meets the needs of the residents. Access to the gardens is limited for those with mobility difficulties. However, there is a decking area with easy access from the rear of the dining room where residents can sit outside in the fine weather. Parklands DS0000022003.V309024.R01.S.doc Version 5.2 Page 16 The entrance hall contained many prizes ready for the Christmas raffle that is a feature of the home each year. The three residents’ rooms that were looked at, each had personal possessions displayed and reflected the personalities of the occupant. The rooms contained all the items that the residents required in order to have their needs satisfactorily met. The home has a variety of hoists and moving and handling aids to enable staff meet the needs of those residents with mobility difficulties. The home was clean and tidy throughout. Staff confirmed that they have access to disposable gloves and aprons, and were aware of good basic hygiene procedures. The District Nurse that was spoken with said that there had been concerns raised by the home over caring for residents with MRSA. The District Nurses had provided some training in dealing with MRSA, and that they were happy with the procedures now being followed. Parklands DS0000022003.V309024.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The deployment and numbers of staff available throughout the day and night are sufficient to meet the needs and numbers of the current residents. The procedures for the recruitment of staff are not entirely robust and do not always offer full protection to residents. A full training programme ensures that staff are competent to meet the needs of residents. EVIDENCE: There were two care staff and one cook on duty as well as the owner and care manager. At night there is one staff member awake and one ‘sleeping in’. Team assistants are also employed to take round drinks and help with domestic tasks. The care staff said that they did not feel rushed at any time and had time to spend chatting to residents. They are looking for ways to increase the activities on offer to residents. Residents told the inspector that there were always staff available if they wanted anything, and that they did not have to wait for help. They also said that they did not want staff around them all the time, as they wanted some independence. Parklands DS0000022003.V309024.R01.S.doc Version 5.2 Page 18 There was a relaxed and unhurried atmosphere around the home, with staff meeting the needs of residents in a quiet and competent manner. The majority of residents at the home have relatively low care needs and staff felt that if resident dependency levels increase that more staff would be available. Over the summer holiday period staff worked extra hours in order to ensure the rota was maintained and residents’ needs were met. There were comments made on questionnaires, that residents’ rooms were not as clean as they usually were as care staff, who normally clean rooms were too busy with care work. However, separate domestic staff are employed. Staff were well aware of the individual care needs of the residents and were able to describe these and how they are met on a day to day basis. Staff spoke with enthusiasm about the residents and their work with them. Three staff files were looked at and all contained two written references, proof of identity and photographs of the staff member. However, not all contained police checks obtained for that staff member by the home. One contained a photocopy of a check from the person’s previous employment and no POVA (Protection of Vulnerable Adults) First check had been obtained. These procedures should be correctly followed as a failure to do so could place residents at risk of abuse. All care staff working at the home have recently obtained NVQ 2, and their files showed evidence of other training including Infection Control, First Aid, Basic Food Hygiene and Fire Safety. Parklands DS0000022003.V309024.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed resulting in practices that generally promote and safeguard the health, safety and welfare of the residents. EVIDENCE: Mr and Mrs Baker have run the home for many years and they are supported by a care manager. Mr Baker has recently completed the Registered Managers Award. Staff were very complimentary about the management team, feeling that they are provided with good support and are praised and encouraged to work as a team. Parklands DS0000022003.V309024.R01.S.doc Version 5.2 Page 20 The home does not manage any money on behalf of residents. Staff records indicated that staff receive regular annual appraisals. A supervision checklist was also seen on their files. However, there was some confusion amongst staff as to exactly what supervision was and whether a ‘general chat’ about things was supervision. The inspector and the management team discussed ways of evidencing more work that takes place at the home, for example staff supervision and quality assurance reviews. The inspector was told that questionnaires are sent out to residents and relatives on the care provided. They also gave examples of how residents are consulted over their life at the home. However, there was no evidence to support this good practice, and a formal system needs to be put in place. Moving and handling assessments have been completed for residents, and there is a full risk assessment of the premises. The pre-inspection questionnaire provided evidence that Parklands complies with health and safety legislation in relation to the maintenance of equipment, storage of hazardous substances, health and safety checks and risk assessments. All radiators are covered and a room safety check is undertaken daily. Staff told the inspector they have been told to look back into the room every time they leave it to ensure that everything is in order. The Fire Log book was well maintained and staff confirmed that they receive regular training in fire precautions as well as Health and Safety. Parklands DS0000022003.V309024.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 3 Parklands DS0000022003.V309024.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO 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 OP29 Regulation 19 (4)(b) Requirement The registered person shall not allow person to work at the care home unless they have obtained in respect of that person the information and documents specified in (i) paragraphs 1 to 7 of Schedule 2 (This relates to obtaining current police checks for all staff) The registered person shall establish, maintain, review and improve the quality of care at the home. The registered person shall consult with service users and their representatives and send a copy of any report prepared to CSCI Timescale for action 31/12/06 2 OP33 24 31/12/06 Parklands DS0000022003.V309024.R01.S.doc Version 5.2 Page 23 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. Refer to Standard OP9 OP36 Good Practice Recommendations You are recommended to ensure that staff sign to say they have administered medication after each individual has received their medicine. You are recommended to ensure there is evidence of any staff supervision that is given. Parklands DS0000022003.V309024.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Devon Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Parklands DS0000022003.V309024.R01.S.doc Version 5.2 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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