Inspection on 01/10/09 for Parkvale House

This inspection was carried out on 1st October 2009.

CQC found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Parkvale House 21/01/08

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Parkvale House 124 Park Avenue Whitley Bay Tyne & Wear NE26 1AY     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Elizabeth Gaffney     Date: 1 4 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 33 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 33 Information about the care home Name of care home: Address: Parkvale House 124 Park Avenue Whitley Bay Tyne & Wear NE26 1AY 01912523952 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Alistair Craig Nurse care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 7 The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Male Whose primary care needs on admission to the service are within the following categories: Learning Disability, Code LD - maximum number of places 7 Mental Disorder, Code MD maximum number of places 7 Date of last inspection Brief description of the care home The home is situated near to the sea front in whitley Bay. It is a three storey terraced house in keeping with the local community. Accommodation is provided over three floors. The home does not have a passenger lift and is therefore not suitable for anyone with a physical disability. There is a lounge, small conservatory, kitchen and dining room located on the ground floor. All bedrooms and other amenities are situated on the first and second floors. The home has a small town garden at the front of the house and there is a courtyard to the rear which is accessible to service users. The Care Homes for Adults (18-65 years) Page 4 of 33 Over 65 0 0 7 7 Brief description of the care home home is close to all local amenities and transport links are near by. The current scale of charges ranges from 350 to 400 pounds. The homes service user guide and statement of purpose are available on request. Care Homes for Adults (18-65 years) Page 5 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. How the inspection was carried out. Before the visit we looked at: - Information we have received since the home was last inspected; - How the service dealt with any complaints and concerns since the last visit; - Any changes to how the home is run; - The acting managers view of how well they care for people. We also interviewed three people who use the service and three staff; Care Homes for Adults (18-65 years) Page 6 of 33 - The views of relatives, other professionals and staff. An unannounced visit was made on 01 October 2009. During the inspection we: - Talked with the registered manager, the acting manager and a senior member of staff; - Looked at information about the people who use the service and how well their needs are met; - Looked at other records which must be kept; - Checked that staff have the knowledge, skills and training to meet the needs of the people they care for; - Looked around the building to make sure it is clean, safe and comfortable; - Checked what improvements had been made since the last visit. Care Homes for Adults (18-65 years) Page 7 of 33 What the care home does well: What has improved since the last inspection? What they could do better: Ensure that peoples support plans cover the areas referred to in the National Minimum Standards as well as any needs identified in each persons Care Programme Approach Action Plan and Community Treatment Order where relevant. Peoples support plans should contain a clear description of their assessed needs and details of the action that will be taken to meet those needs. Support plans should also contain a statement of desired outcomes. Ensure that all staff receive Level 1 training in handling medicines. Staffs competency to administer medication should be assessed on a regular basis. The homes medication arrangements should be regularly checked by an experienced pharmacist. Peoples medication should be stored in a cabinet which complies with the relevant British Standard and the cabinet should only be used for the storage of medication. Staff should ensure that there is written evidence that service users competency to administer their own medication has been assessed. Where appropriate, each person should have a medication support plan which sets out the support that the home will provide with the administration of their medication. Ensure that all staff complete local authority safeguarding training. Documentary evidence that staff have completed this training must be available within the home. Care Homes for Adults (18-65 years) Page 8 of 33 Revise and update the homes safeguarding policy and procedures to ensure that they are compliant with the local authoritys safeguarding procedures and current legislation. This will help to make sure that staff are clear about the steps they should take to keep people safe. Ensure that all staff complete certificated infection control training. The Department of Health checklist for assessing infection control measures should be completed and an appropriate action plan devised. This will help to promote and protect peoples health and well-being. Ensure that robust staff recruitment procedures are in place. This will help to ensure that only suitable staff are employed to work at the home. Ensure that newly employed staff complete training in the Skills for Care Common Induction Standards. All staff must complete the required mandatory training. All staff should complete specialist training that is relevant to the needs of the people they support. This will help to make sure that people are cared for by staff who have appropriate skills and competencies. Ensure that robust workplace risk assessments are carried out. Regular health and safety checks should also be carried out and a written record of the outcome kept. This will help to promote peoples health and well being. Make sure that weekly tests of the fire alarm system are carried out. Ensure that staff working day shifts receive fire instruction every six months and night staff every three months. Documentary evidence confirming this should be kept. This will help to make sure that staff are clear about the steps they should take to keep people safe in the event of a fire. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 33 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 33 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for making sure that peoples needs are assessed before they are admitted into the home are generally satisfactory. This means that people can be confident that staff will know how to meet their needs following admission into Parkvale House. Evidence: The homes service user guide provides people interested in using the service with helpful information about what they can expect once they move into Parkvale House. The guide contains all of the required information with the exception of service users views of the home and the size of individual bedrooms. The Expert by Experience said all of the service users described a gradual introduction to the service, spending at first half a day at the accommodation and increasing at each visit to include overnight stays and meeting of other service users. They all said they felt supported and not pressurised into the move. They also said that the process and the homes policies, rules and procedures were explained to them Care Homes for Adults (18-65 years) Page 11 of 33 Evidence: very clearly before they made the decision to move to Parkvale House. Each service user had previously been living in a hospital environment and they all described how much better their lives became after the move. The care records of three people were looked at as part of this inspection. These showed that the home carries out its own in-house pre-admission assessment for each person. Staff said that this helps the home to reach a decision about whether a suitable placement that will meet peoples needs can be provided. However, it was identified that one of the assessments had not been fully completed. Copies of the assessments carried out by relevant social and healthcare professionals were not available in some peoples care records. Failure to obtain this documentation could lead to staff being unclear about how to meet peoples needs following their admission into the home. However, service users told the Expert by Experience that their move into Parkvale House was discussed and agreed with their social workers as part of their discharge from hospital. Senior staff reported that each person was expected to participate in an extended introduction to Parkvale House lasting approximately six months. They also said that staff used this time to get to know each person and obtain their views about how their needs should be met. Care Homes for Adults (18-65 years) Page 12 of 33 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home feel that their needs are being met. However, for some people appropriate support plans and risk assessments have not been completed. Because of this, staff do not have clear guidance on how to support people. Evidence: People using the service told the Expert by Experience that their individual needs are well met and they are fully involved in the preparation of their support plans. They told the Expert by Experience that they are encouraged to attend any review meetings held at the home. They also said that staff are very good at involving them in decisions about their life at the home and confirmed that access to advocacy services is arranged when support is needed to make a decision. The Expert by Experience reported that one service user had described how they had been able to negotiate a free hour away from their one-to-one escort at their Care Programme Approach review meeting. A sample of the care records held in the home was looked at as part of the inspection. Care Homes for Adults (18-65 years) Page 13 of 33 Evidence: This showed that a range of support plans have been devised for people living at Parkvale House. However, a number of concerns were identified: * Support plans covering the following areas have not been devised for each person: psychological and physical health; employment and education; social, spiritual and cultural life; medicines management; relapse prevention and, where relevant, offending behaviour. Also, peoples support plans do not cover all the areas identified by their community health worker; * In one persons care records, there were no support plans. This is of concern as the action plan devised by their community health worker identifies that they require support in a variety of areas; * Some of the people living at Parkvale House are subject to Community Treatment Orders. However, accompanying support plans have not been put in place; * Some support plans do not include a clear and detailed description of peoples needs or desired outcome statements; * None of the support plans checked had been signed by the service users. Senior staff spoke about the safeguards that are in place to support people to take appropriate risks. Staffs work in this area is underpinned by a risk assessment policy and supportive procedures. The manager emphasised that peoples safety is taken seriously and risk assessments are carried out wherever staff identify potential areas of concern. Copies of risk assessments carried out by other professionals have been obtained. Staff spoke knowledgeably about some of the risks that people using the service face on a day to day basis. However, written evidence that robust risk assessments have been carried out is generally not available. Failure to carry out robust written risk assessments could mean that staff are not clear about all of the actions they should take to keep people safe. The majority of staff who returned surveys said they are given up to date information about peoples needs and the ways of sharing information between shifts works well. Care Homes for Adults (18-65 years) Page 14 of 33 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to choose how they want to live their lives, and they receive the level of staff support that suits them. This means that people are able to benefit from living in a home where staff support them to engage in their community, be more independent and live a healthy lifestyle. Evidence: People are supported to take part in culturally age appropriate activities and to make use of community based facilities. The Expert by Experience reported that each person described how they are supported to access a range of educational, employment and recreational opportunities. Service users told the Expert by Experience that their need for a one-to-one escort when accessing the community did not prevent them from doing the activities that they were interested in. Service users said that providing them with access to meaningful activities is a major of Parkvale Houses philosophy. One service user told the Expert by Experience that he was Care Homes for Adults (18-65 years) Page 15 of 33 Evidence: interested in sport and pursues his interest in football by playing for the local team. He also said that he cycles regularly, attends a local gym and is employed on a gardening project developed by the provider. He said that he is hoping to enrol at the local college and is shortly due to take an admissions numeracy test. This person told the Expert by Experience that he had arranged to go shopping to buy food which he would cook for the rest of the household that evening. A second service user reported that he enjoyed shopping and going to the pub. This person reported that they also work at the gardening project, and although his interests do not include sport, he confirmed that he is well occupied. He said that he is a keen cook and regularly makes meals for other people living at the home. A third service user said that he attends the local college and enjoys going shopping. Staff have access to a people carrier and mini-bus which enables them to offer service users access to group trips and outings. A senior member of staff has recently completed a cycling proficiency qualification which they hope will enable the home to offer further work placement opportunities. Meal planning takes place on an individual basis which ensures that people receive the support they need to become independent in this area. Service users are encouraged to have a healthy diet, shop for their own food and prepare meals for themselves and other people living at the home. Service users said that they receive the support they need to develop skills in meal preparation and using the kitchen. Service users were seen accessing the kitchen to make snacks and drinks. Staff support was available. Service users also said that they are encouraged to eat in the homes dining room, but are able to eat in their bedrooms if they wish. Where people have special dietary needs, staff ensure that these catered for. On the day of the inspection the kitchen was clean, hygienic, tidy and well equipped. There was a pleasant atmosphere during the meal time that was observed. Staff support people to keep in contact with family members and friends, and there was evidence of this in service users records. Care Homes for Adults (18-65 years) Page 16 of 33 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for meeting peoples personal and healthcare needs are not fully satisfactory, and because of this, some of their needs may not be met. Evidence: None of the people living at the home require assistance with mobilising or have intimate personal care needs. Service users are registered with a local GP. Two of the service users whose records were looked at had received optical care during the previous 12 months. Arrangements had been made for one of these people to receive dental care. Access to healthcare professionals, such as specialist nurses, is arranged as and when needed. Service users said that staff support them to attend healthcare appointments, such as hospital psychiatry, when required. However, support plans addressing peoples health care needs have not been devised. For example, it is recorded in one service users CPA Action Plan that they have asthma and a history of seizures. However, support plans setting out the action that staff should take to meet this persons needs have not been devised. People said that they are provided with good support and staff look after them very well. Where appropriate, all medication has original prescription labels attached. Controlled Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: drugs are not used within the home. There is no evidence that any medication has been given in error since the last inspection. The homes medication records are generally well maintained and help to promote peoples health and well-being. Staff have obtained the permission of peoples GPs to enable specified non-prescription medicines to be administered. Some people living at the home administer their own medication. However, a recorded risk assessment of their competency to administer their own medication has not been completed. Staff files do not contain documentary evidence that they have completed Level 1 induction training in medication as recommended by the Care Quality Commission. There is also no evidence that staffs competency to administer medication has been assessed. There are no arrangements for the homes medication policy, procedures and practices to be assessed by an experienced pharmacist on a regular basis. All medication is stored in a locked cabinet. However, the homes storage arrangements do not comply with the British Royal Pharmaceutical Society guidelines which state that all medicines should be stored in a cabinet which complies with the relevant British Standard. Also of concern is that items such as peoples money are stored in the cabinet in which medicines are kept. Care Homes for Adults (18-65 years) Page 18 of 33 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for handling complaints and managing safeguarding concerns are generally good. This means that people are able to benefit from living in a home where concerns about their safety are promptly addressed and their views listened to and acted on. Evidence: Details of the homes complaints procedure are included in the service user guide. A copy of the procedure is on display in the homes reception area. The procedure can be made available in large print or in an audio format if necessary. Neither the home nor the Commission have been notified of any complaints since the last inspection. Of the ten staff that returned surveys, all confirmed that they have been told how to handle complaints. The Expert by Experience reported: Each person said they would feel confident about making a complaint if this became necessary. They all said they would first talk to staff if they had a problem and would pursue it through management if it was not dealt with satisfactorily. One service user said, I know my rights inside out, and I would make a complaint if I needed to. People said that they feel very safe living at Parkvale House. Service users who returned surveys said that they had been told who to speak to if they were not happy and confirmed that they were clear about how to make a Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: complaint. The home has a safeguarding policy and associated procedures. However, the policy has not been updated to reflect the homes responsibilities and duties under new legislation such as the Mental Capacity Act and Deprivation of Liberty Regulations. Also, the policy does not provide details of how the homes practice complies with the local councils safeguarding protocols. Staff are clear about the action they would take to keep people safe and free from harm. Neither the home nor the Care Quality Commission have been notified of any safeguarding concerns. Although the homes Annual Quality Assurance Assessment states that all staff have received safeguarding training, none of the staff files looked at contained documentary evidence to confirm this. Care Homes for Adults (18-65 years) Page 20 of 33 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for ensuring that the premises are well maintained are good. This means that people are able to benefit from living in a home that has good facilities and is appropriately decorated and furnished. Evidence: The home is a large, family house situated in a residential area in Whitley Bay. It is indistinguishable from neighbouring houses. People said that they have been involved in choosing the decor, furnishings and fittings in their bedrooms. All bedrooms have been personalised to reflect the preferences of the occupant. The house is generally well decorated and furnished, comfortable, warm and clean. Some areas of the home have been refurbished since the home re-registered as Parkvale House. For example, the rear conservatory has been extended to create a larger and more useable office area. The external rear area has been repainted. The electrical fittings in this area have been improved. New furniture has been purchased for some of the bedrooms and all rooms have been redecorated. New beds have been provided in the majority of rooms as well as new flooring and soft furnishings. The dining and lounge areas have been refurbished. New lighting has been installed in the dining room. The home confirmed in its Annual Quality Assurance Assessment (AQAA) that the Department of Health checklist for assessing infection control measures in residential Care Homes for Adults (18-65 years) Page 21 of 33 Evidence: care homes has not been completed. The AQAA also confirmed that only two staff have completed infection control training. No hazards or health and safety concerns were identified during the inspection. All of the people who returned surveys said that the home is always or usally clean and fresh. The Expert by Experience reported: Each person has lived in Parkvale House for approximately a year. Service users described how, during that time, the accommodation has improved considerably. They said that they are happy with their bedrooms and with the public rooms. They also said that food is good. Care Homes for Adults (18-65 years) Page 22 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by qualified staff who are available in sufficient numbers to meet their needs. However, the arrangements for carrying out robust pre-employment checks, and for providing staff with relevant induction training and formal supervision, are not satsifactory. Because of this, people do not benefit from being cared for by staff who have undergone robust employment checks and appropriate training and support. Evidence: There are rotas that show which staff are on duty and at what times. The staff team consists of 12 support staff, including the acting manager. The rotas show that for up to seven service users there is always a minimum of four staff on duty between 8 am and 8 pm. In addition, extra staff are rostered on duty during busier times of the day or to support people attending community based activities. A waking member of staff covers the night time period and one member of staff sleeps over in the building each night. The rotas do not contain staffs full names or their designations or details of the hours worked by the registered manager. Also, the rota shows that some sleep over shifts have been worked by agency staff. However, the rotas do not include the names of these staff. The home took action to improve the rota format whilst the inspection was taking place. Care Homes for Adults (18-65 years) Page 23 of 33 Evidence: An examination of the homes records showed that a range of pre-employment checks are carried out before staff can start working at Parkvale House. For example, staff are required to complete an application form, provide statements about their physical and mental health and confirm whether they have any convictions. Also, two written references are obtained. However, one of the files checked did not contain an identification photograph and one member of staff had not provided a full employment history. There is also no documentary evidence that staffs identities have been checked and verified. It was also identified that one member of staff had commenced working at the home without either a Criminal Records Bureau (CRB) certificate or a POVA First check. A CRB certificate was obtained six weeks after their employment started. There is documentary evidence that staff have received a thorough in-house induction. However, there is no evidence that staff appointed within the last 12 months have completed training in the Skills for Care Common Induction Standards. Management staff reported that support workers are expected to complete and regularly update their mandatory training. However, there was no documentary evidence in some of the personnel files checked that staff had completed training in moving and handling, infection control, food hygiene awareness, first aid, fire safety and health and safety. Staff said that they have received the training they need to do their job. They also said that the acting manager is always trying to source new training opportunities for them. Staff files do not contain documentary evidence that they have completed specialist training relevant to the needs of people with learning disabilities or mental health needs. However, over 85 per cent of the staff team have obtained a National Vocational Qualification in Care at Level 2 or above. Arrangements are in place for staff to receive supervision. Staff who returned surveys said that the acting manager gives them enough support and meets with them regularly to discuss how they are working. Staff also said that they have enough support, experience and knowledge to meet the different needs of people living at the home. However, staff have not been receiving supervision at the frequency stated in the National Minimum Standards. Care Homes for Adults (18-65 years) Page 24 of 33 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for protecting and promoting peoples health and safety are not fully satisfactory. This means that people are unable able to fully benefit from living in a well run home where their health, safety and welfare is treated seriously. Evidence: The provider, who is also the registered manager, successfully registered with the Commission in 2007. However, the provider intends to submit an application to register the acting manager. Arrangements are in place to monitor the quality of the service. For example: * People are encouraged to complete satisfaction surveys. Six people had recently returned surveys and rated the care and support they receive as either good or excellent; * Quality management visits are carried out. The report prepared for 2008/09 showed Care Homes for Adults (18-65 years) Page 25 of 33 Evidence: that an assessment of the homes day to day performance in a range of key areas, such as service users well being and care planning, had been carried out. However, the provider submitted an Annual Quality Assurance Assessment that did not contain sufficient evidence to support the self-assessment judgements reached by the home. The acting manager confirmed that the home does not have an annual development plan. People are encouraged to take responsibility for managing their own finances. A small number of people require assistance in this area and the registered manager acts an Appointee for two of these individuals. Where peoples money is managed by staff, it is kept separately and secure at all times. A cash book is kept and includes details of when money is deposited and withdranw. A sample of records was checked against the actual balances held, all were found to be correct. However, a number of concerns were identified: peoples care records do not include details of their preferences regarding how they want their money to be handled; an assessment of the risks posed by people handling their own money has not been carried out; financial support plans are not in place. Action is taken to promote peoples health and safety. For example, the home has an up to date fire risk assessment and monthly visual checks of the emergency lighting system are carried out. There is a current gas safety certificate and the homes boiler has been checked during the previous 12 months. Checks of the safety of electrical equipment used in the home has been carried out within the last 12 months. A senior member of staff reported that regular health and safety checks are to be carried out and a written record kept. However, a number of concerns were identified: * There is no documentary evidence that weekly tests of the fire alarm system are taking place; * The fire records do not contain documentary evidence that some staff have attended at least two fire drills, or received fire prevention training at the recommended frequency, during the last 12 months; * Only a limited range of workplace risk assessments have been completed. However, the home took action to address this concern whilst the inspection was taking place. Care Homes for Adults (18-65 years) Page 26 of 33 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 33 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 12 Ensure that support plans are devised for people who have assessed healthcare needs. This will help to ensure that staff are clear about the action they must take to support people to lead healthy lifestyles. 01/04/2010 2 34 18 Ensure that: * A Criminal Records Bureau (CRB) certificate is obtained for each member of staff; * A POVA First check is obtained for any member of staff who commences working at the home pending a satisfactory CRB certificate; * Where staff commence work with only a POVA First, an experienced member of staff is identified to oversee 01/04/2010 Care Homes for Adults (18-65 years) Page 28 of 33 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action their work and ensure that they do not work unsupervised. This will help to ensure that only suitable staff are employed to work at the home. 3 34 18 Ensure that: * A full employment history and an identification photograph are obtained for each member of staff; * Staffs identities are checked and verified. This will help to ensure that only suitable staff are employed to work at the home. 4 35 18 Ensure that staff complete training in moving and handling, first aid, food hygiene, infection control, health and safety and fire prevention. This will help to ensure that people are cared for by staff who have appropriate skills and competencies. 5 36 18 Ensure that staff receive formal supervision at least six times a year. A written record should be kept. 01/02/2010 01/02/2010 01/04/2010 Care Homes for Adults (18-65 years) Page 29 of 33 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action This will help to ensure that people using the service are able to benefit from being cared for by staff that are properly supported and supervised. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 Ensure that the homes service user guide is revised to include: * Service users views of the home; * Details of bedroom sizes. 2 2 Ensure that the homes in-house pre-admission assessment is fully completed before an admission into Parkvale House takes place. Ensure that a copy of the social services/healthcare needs assessment is obtained before a decision is made to offer a placement at the home. Ensure that people are encouraged to sign the support plans that have been devised to make sure that their needs are met. Ensure that peoples support plans: * Cover the areas referred to in the National Minimum Standards as well as any needs identified in the persons Care Programme Approach action plan/Community Treatment Order; * Contain a clear description of their assessed needs and details of the action that will be taken to meet those needs; * Contain a statement of desired outcomes. 3 2 4 6 5 6 Care Homes for Adults (18-65 years) Page 30 of 33 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 6 20 Ensure that: * All staff receive Level 1 training in handling medicines; * Staffs competency to administer medication is assessed on a regular basis where relevant; * The homes medication arrangements are regularly checked by an experienced pharmacist; * Peoples medication is stored in a cabinet which complies with the relevant British Standard. The cabinet should only be used for the storage of medication; * There is written evidence that service users competency to administer their own medication has been assessed; * Where relevant, each person has a medication support plan which sets out the support that the home will provide with the administration of their medication. 7 23 Revise and update the homes safeguarding policy and procedures to ensure that they are compliant with the local authoritys safeguarding protocol, Mental Capacity Act and Deprivation of Liberty Regulations, and the introduction of the Independent Safeguarding Authority. The revised policy and procedures should be forwarded to the North Tyneside Safeguarding Team for comment. Ensure that all staff complete local authority safeguarding training. Documentary evidence that staff have completed this training must be available within the home. Ensure that: * All staff complete certificated infection control training; * The Department of Health checklist for assessing infection control measures is completed and an action plan drawn up. 8 23 9 30 10 11 34 35 Ensure that there is documentary evidence of the outcome of staff interviews. Ensure that staff personnel records contain documentary evidence that they have completed the required statutory training. Page 31 of 33 Care Homes for Adults (18-65 years) Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 12 35 Ensure that newly employed staff complete training in the Skills for Care Common Induction Standards. A certificate of completion verified by the manager should be available within the home. Ensure that arrangements are made for staff to complete specialist training that is relevant to the needs of the people they support. Ensure that: * Weekly tests of the fire alarm system are carried out and appropriate records kept; * Staff working day shifts receive fire instruction every six months and night staff every three months. Documentary evidence confirming this should be kept. 13 36 14 42 15 42 Ensure that: * Robust workplace risk assessments are carried out; * Regular health and safety checks are carried out and a written record of the outcome kept. Care Homes for Adults (18-65 years) Page 32 of 33 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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