Inspection on 15/11/06 for Parkstone Lane

This inspection was carried out on 15th 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

Parkstone Lane 06/03/08

Parkstone Lane 06/02/06

Parkstone Lane 03/10/05

Parkstone Lane 16/02/05

Parkstone Lane 04/08/04

Parkstone Lane 24/03/04

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 Parkstone Lane 31 Parkstone Lane Plympton Plymouth Devon PL7 4DX Lead Inspector Tina Maddison Unannounced Inspection 15th November 2006 10:00 Parkstone Lane DS0000003561.V302145.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 Parkstone Lane DS0000003561.V302145.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. Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parkstone Lane Address 31 Parkstone Lane Plympton Plymouth Devon PL7 4DX 01752 344144 01752 344144 headoffice@durnford.org 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) The Durnford Society Limited Mrs Sarah Reilly Care Home 4 Category(ies) of Learning disability (4), Physical disability (4) registration, with number of places Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 4 people who are learning disabled who may also have a physical disability and are aged between 18 - 65 years may be accommodated at any one time 6th February 2006 Date of last inspection Brief Description of the Service: Parkstone Lane provides care for four people who have profound learning disabilites and may have physical disabilities. The house is owned by The Health Authority and managed by The Durnford Society that is a registered charity. The property consists of a large detached house that stands in its own grounds and has large gardens. All service users are accommodated in single rooms. The home is situated near the town of Plympton and has the use of its own transport. Parkstone Lane DS0000003561.V302145.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 on the 15th November 2006. Prior to the inspection survey forms were received back from four service users, who were assisted to complete them by an independent advocate, one form was returned by a General Practitioner, and one survey form was returned from relatives of a service user. Also prior to the inspection a detailed pre inspection questionnaire was returned by the Registered Manager. Two members of staff were spoken with by the Inspector during the Inspection. Two relatives visiting the home were also spoken with to gain their views that inform this report. Service users at the home were unable to fully articulate their views but appeared to be happy and relaxed throughout the inspection. A tour of the building was undertaken during the inspection, including all four service users bedrooms. A variety of records and documents were examined that related to the service users, staff and health and safety. What the service does well: Parkstone Lane provides a highly individualised good standard of care to the four service users who have profound learning disabilities and physical disabilities. Their care needs are complex, and are competently met by a staff team who are committed, caring and well trained. Service users are enabled to be as independent as possible with all daily living tasks. It was observed during this inspection that the increasingly complex care needs of one service user were being met through the construction of a downstairs specially adapted bedroom and bathroom and training for the staff team that is commendable and the standard relating to this individualised care is exceeded. The property is wholly suitable for the needs of the service users, and offers clean, warm and homely accommodation. Parkstone Lane offers a level access large garden that is fully accessible to the service users. Two thank you cards from relatives were on display and stated that the relatives of a service user thought that the staff were “just fantastic”. Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. Parkstone Lane DS0000003561.V302145.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 Parkstone Lane DS0000003561.V302145.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. Quality in this outcome area is adequate because service users can be assured that their care needs will be assessed prior to admission to the home and that the staff at Parkstone Lane will be able to meet their care needs. Service users would benefit from the service user guide being produced in an accessible format. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There had been no change of service users since the previous inspection. The statement of purpose for the home needs updating to reflect changes in management and staff. The service users guide in its present format is not accessible to the service users at the home. The deputy manager told the Inspector that both of these documents are currently being reviewed. A service user confirmed in their returned survey form that they had the opportunity to visit the home prior to admission. Service user files that were examined evidenced that their care needs were fully assessed prior to admission to ensure that the home could meet their care needs. Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9. Quality in this outcome area is good because service users can be assured that staff will enable them to be as independent as possible, and they will be supported to safely participate in all aspects of life at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three individual care plans were examined during this inspection. It was found that one of the plans was very detailed and covered all areas of health and welfare including very detailed instructions to staff regarding how the individuals complex health needs were to be met. Included in the files were details of a moving and handling plan, and a statement of nursing needs. The parents of this service user also commented that they thought that their relatives changing and complex care needs had been well managed by the Manager and staff at the home. A key worker system is in place at the home, and this ensures continuity for the service users, and this is important, as most of the service users are not able to express their needs verbally. Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 11 Staff were observed during the inspection communicating effectively with the service users by using their knowledge of how the individual communicated and what this meant, and the staff were observed to note the service users body language and interpret this appropriately. It was evident from the care plans and risk assessments for individual service users that risk and choices are appropriately balanced. Risk assessments on files also evidenced that the service users are able to take responsible risks that had been assessed, and risk management strategies were in place. One of the service users needs one to one staffing when outside of the home, and this restriction on personal freedom should be documented as agreed with representatives of the service user. Relatives of a service user who were spoken with at the inspection confirmed that service users are encouraged to be as independent as possible in the home, and examples of how they are encouraged to participate in the daily life of the home included choosing the menus, shopping and helping with daily household tasks. This activity was observed during the inspection. Minutes of the service users meetings evidenced that service users opinions and choices regarding daily life at the home are taken into account. Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,14,15,16,17. Quality in this outcome area is good because service users rights and responsibilities are respected. Families are welcome to visit at any time. Meals provided at the home are varied and nutritious. This judgement has been made using available evidence including a visit to this service. EVIDENCE: None of the service users at Parkstone Lane are able to undertake employment and the staff at the home provide a variety of activities. These were documented as including visits to the aquarium, seal sanctuary and a variety of outdoor activities during the summer. Individual likes and dislikes regarding activities were recorded on care plans. The Deputy Manager stated that the staff were considering compiling a photographic daily planner for one resident, so it was clear to them what activities were planned for specific days. Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 13 Service users have benefited from individual holidays to Spain, a five day stay in a holiday cottage, and individual day trips depending on individual interests and preferences. It was observed by the Inspector during the inspection that staff knocked on bedroom doors before entering and were respectful of service users privacy. All bedrooms are fitted with locks, but none of the current service users use their keys, and this is recorded as agreed with their families and care managers. One relatives survey form was returned, and confirmed that families are always welcome at the home and can visit at any time. Relatives who were spoken to by the Inspector during the inspection confirmed that they were always kept informed of their relatives progress and any health issues. They confirmed that the staff helped their relative choose birthday and Christmas cards to send to the family. On the day of the inspection it was one service users birthday, and staff had bought them a card and present, and were assisting them to open their other presents and cards, and generally appeared to be creating a happy and special day. Menus evidenced a varied and healthy diet is provided at Parkstone Lane. Service users confirmed that they liked the meals. Special diets were recorded as being catered for. Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Quality in this outcome area is good because service users can be assured that staff at Parkstone Lane will treat them with respect, and their care needs will be given in the way that they prefer. Standard 19 is exceeded due to the exceptional way in which one service users increasing health needs are being met at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The four service users currently living at Parkstone Lane require assistance with their personal care. Staff spoken with were clear about individual care needs and how the service users preferred these to be undertaken. Care plans documented individual physical and emotional health care needs. It was documented on care plans that advice and support had been obtained from Physiotherapy, and subsequently a service user benefits from the user of a hoist, sling and a specialist bed and mattress that meet their health care needs. The home has a policy and procedure for the administration of medication, and this procedure has recently been reviewed and simplified to ensure that errors are not made by staff. A fridge has been purchased to ensure that ointments and other medication are stored at appropriate temperatures. Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 15 Medication dispensing record sheets were examined and evidenced a good standard of recording. A photograph of individual tablets and their side effects were available for staff. Staff confirmed that they have received appropriate medication training. A survey form from a General Practitioner who visits the home stated that in their opinion the home runs very well, and the GP had no concerns regarding the homes handling of medication and the service users health needs. None of the service users self medicate. The representatives of all four service users have consented for the staff at the home to administer medication. Staff had received training in a variety of topics relating to meeting the health needs of the service users, including diabetes and challenging behaviour. Staff did indicate that they believed that further training by an external provider regarding epilepsy would be helpful and would further their knowledge of this condition. Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good because service users can be confident that their views will be listened to and concerns and complaints will be taken seriously, acted upon and resolved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There had not been any complaints made to the Commission for Social Care Inspection since the previous inspection. The home had a complaints procedure, although this is not currently displayed in the home in a format that the service users could understand and use. The survey forms returned indicated that families did know how to complain and to whom. Concerns and complaints are recorded with actions taken to remedy the concern or complaint. An independent advocacy service provided by Mencap is used by one service user, and a befriender who is a member of staff who works in another Durnford Society home acts as an advocate for another service user. There is a whistle blowing policy and procedure that staff indicated they felt able to use if necessary. There is a vulnerable adults procedure, and staff had received adult protection training. From discussion with the Deputy Manager and staff, it was clear that they understood situations where physical or verbal aggression is used by the service users, and were aware of how to deal with it appropriately. Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 17 The financial records of three service users were examined, and evidenced that their financial interests are protected, and their money is used appropriately for them. Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30. Quality in this outcome area is good because Parkstone Lane offers a clean, well maintained, comfortable and homely environment to the service users who live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the previous inspection, a good deal of building work had been undertaken at Parkstone lane. These include the completion of an extension incorporating an ensuite bedroom that has been built with the individual care needs of a service user in mind. This extension also incorporates a pleasant conservatory area. New kitchen units have been fitted, and replacement fire doors have been installed. The hot water tanks have been replaced to ensure an efficient hot water system. All of the four service users have single bedrooms that were found to be pleasantly decorated and individualised. The two service users spoken with Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 19 said that they liked their bedrooms. The relatives of the service user who occupies the new downstairs bedroom said that they were delighted with it and felt that their relatives care needs could now be fully met. On the day of the inspection it was a cold day, but the home was found to be warm, very clean and tidy. All radiators are fitted with covers and hot water outlets are fitted with water temperature control valves. The three service users who have bedrooms on the first floor share a large bathroom and two toilets. The service users have the use of a large lounge, and a dining room and kitchen. Parkstone Lane is a large detached house that is set in its own grounds. The rear garden is a pleasant area that is fully accessible to the service users. Disability equipment is available where needed, and includes hoists, and adapted bath and toileting equipment. There is an infection control procedure operating in the home that staff are familiar with. It was found that there was ample hand washing facilities, and plenty of soap and clean towels available in the bathrooms to help to control the spread of infection. Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good because service users are supported by an effective and well trained staff team. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From observations made by the Inspector throughout the inspection, it was evident that the staff on duty had formed positive and enabling relationships with the service users. Training records evidenced that the Durnford Society provide a comprehensive range of training opportunities that resulted in well trained and appropriately skilled care staff. The Deputy Manager commented that the staff team have been well motivated and committed during a period where the newly appointed Registered Manager has had to take long term sick leave, and therefore her absence had not adversely affected the care given to the service users. The records of three members of staff were examined during the inspection. These evidenced that the recruitment procedure is robust, and all three files contained the necessary documents and checks. Staff rotas were examined, and evidenced that adequate numbers of staff were on duty at all times. Agency staff were used when necessary to fill gaps on the Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 21 rota. Relatives spoken to at the time of the inspection commented that they believed that there was always adequate numbers of staff on duty. The home had a training plan, and The Durnford Society employs a training officer who organises and plans training activity for the staff. In the absence of the Registered Manager, supervision for staff was being provided by the Deputy Manager. One member of staff who was spoken with during the inspection commented that they believed that there was a positive atmosphere amongst the staff at Parkstone Lane, and despite the building work that has been going on recently and the absence of the Registered manager, the staff had pulled together and provided continuity of high quality care for the service users. Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good because the health, safety and welfare of service users is promoted and protected at Parkstone Lane. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager, Mrs Reilly was appointed earlier this year but due to sick leave has been absent from the home for a number of months. In her absence the home has been managed by the Deputy Manager. A quality assurance system has been implemented and is overseen by the head office. The Deputy Manager stated that questionnaires had gone out to relatives and involved professionals, and the questionnaires had been returned to the head office but no results had been made available to the home as yet. The Durnford Society undertakes recorded monthly monitoring visits to assess the quality of care at the home. Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 23 Health and safety is well managed at the home, and examination of gas and electrical system maintenance records, fire safety equipment maintenance records and fire prevention training records, and portable electrical appliance testing found that all were all in date. Risk assessments are in place for all safe working topics. An accident recording book is maintained for staff and service users. Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 x LIFESTYLES Standard No Score 11 3 12 3 13 x 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 4 x 3 x 3 x x 3 x Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action 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 YA1 Good Practice Recommendations The statement of purpose for the home should be updated to reflect recent changes in Manager and alterations to the building. The service users guide should be produced in a format that is accessible to the service users at Parkstone Lane. Service users individual care plans should document any restrictions on freedom for a service user, and who these have been agreed with. The homes complaints procedure should be displayed in the home in a format that is accessible to the service users living in the home. The staff team at Parkstone Lane should undertake training by an external provider regarding the management of epilepsy 2 3 4 YA6 YA22 YA35 Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 26 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 Parkstone Lane DS0000003561.V302145.R01.S.doc Version 5.2 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!