Inspection on 06/08/07 for Parkwood House

This inspection was carried out on 6th August 2007.

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

Parkwood House 08/06/06

Parkwood House 18/11/05

Parkwood House 07/06/05

Parkwood House 21/02/05

Parkwood House 29/12/04

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

CARE HOME ADULTS 18-65 Parkwood House West Street Harrietsham Maidstone Kent ME17 1JZ Lead Inspector Mrs Sue Gaskell Key Unannounced Inspection 6th August 2007 11:00 Parkwood House DS0000023988.V343189.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 Parkwood House DS0000023988.V343189.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. Parkwood House DS0000023988.V343189.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parkwood House Address West Street Harrietsham Maidstone Kent ME17 1JZ 01622 859710 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) parkwoodhouse@counticare.co.uk Counticare Limited Les Standley Care Home 13 Category(ies) of Learning disability (13), Physical disability (3) registration, with number of places Parkwood House DS0000023988.V343189.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Three service users who have a physical disability also have a learning disability Date of last inspection 12th September 2006 Brief Description of the Service: Parkwood House is a home for younger adults with a learning or physical disability and is owned by Counticare, a part of CareTech. It is a detached property with extensive grounds, garden (incorporating a sensory garden) and car parking for several vehicles. Also on site adjacent to the main building is a separate small day care unit, which provides activities of a more educational nature. A further facility containing a range of soft furniture and aids for relaxation is also available for use by service users. The home is situated on the outskirts of Harrietsham village lying on the main Ashford to Maidstone road. Facilities such as shops etc are within walking distance. There is good access to bus services and a main line station is situated in the village itself. The fee ranges from £1000 to £1600 per week. Parkwood House DS0000023988.V343189.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 6th August 2007 between 11.00 and 16.30. There were 11 people living at the home and there are two vacancies. I spoke to five residents, the registered manager, and four members of staff. Some residents have limited communication and therefore I mixed with residents and staff for a while in order to see whether the residents appeared relaxed and comfortable. I toured the building and looked at all communal areas. Two residents showed me their bedrooms. The inspection process also consisted of information collected before and during the visit to the home, and feedback from the parents of three residents and three care managers after the site visit finished. Other information seen included pre-admission assessments, various risk assessments, care plans, medication records, the duty rota and staff recruitment and training records. There were no outstanding requirements from the previous inspection and no requirements made following this inspection. Further, some of the overall judgements, eg management of the home, would have been rated as excellent rather than merely good had the home been able to provide evidence of sustainability. What the service does well: The home prepares clear and comprehensive care plans, which assists staff in providing consistent and appropriate care. The food is varied, nutritious and well presented. Staff are well trained and well supported. The home provides a homely, safe, clean environment. Parkwood House DS0000023988.V343189.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 be made available in other formats on request. Parkwood House DS0000023988.V343189.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Parkwood House DS0000023988.V343189.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 People who use the service experience excellent outcomes in this area. The statement of purpose, service user guide and individual statement of terms and conditions, clearly says what service will be offered. Prospective residents can be confident that their needs will be assessed and can be met This judgement has been made using available evidence including a visit to this service. Parkwood House DS0000023988.V343189.R01.S.doc Version 5.2 Page 9 EVIDENCE: The statement of purpose has been reviewed since the last inspection to include all services available to, and used by the residents. All residents are issued with a service user guide. Residents also are issued with individual agreements stating their terms and conditions of residence. Although this information is also provided in a pictorial format not all residents find it easy to understand. The manager said that where this is the case, staff make every effort to explain things to residents. There have been two residents admitted to the home since the last inspection visit. These residents’ files contained a detailed and comprehensive preadmission assessment. Both residents made several visits to the home prior to moving in and one resident’s parent referred to the care taken by staff to enable their son to settle in. Parkwood House DS0000023988.V343189.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 & 9 People who use the service experience good outcomes in this area. The care plans are easy to use and descriptive. Residents’ choices are respected and their decision-making is well supported. Residents are supported in taking risks in the daily and social activities that form part of an independent lifestyle. This judgement has been made using available evidence including a visit to this service. Parkwood House DS0000023988.V343189.R01.S.doc Version 5.2 Page 11 EVIDENCE: All of the residents who were either spoken to, or around during the inspection, were seen to be relaxed and comfortable interacting with staff. Two residents showed me their rooms and said that they like them. All residents have a care plan and 5 were examined in detail. The files include personal profiles, assessments, likes and dislikes, and guidelines on how the home will assist residents in achieving their short and longer term goals. Residents have key workers who monitor their individual needs and activities and help them understand, and contribute as much as possible to, the contents of their care plans. Comprehensive risk assessments have been prepared for each resident’s needs or activities, and include specific guidelines on how to minimise any risk. The records showed that staff sign to acknowledge having read these guidelines. One less experienced member of staff said that he found the guidelines very helpful. The staff rota indicates that staffing is appropriate to residents’ needs with a senior support worker and three carers on shift during the day in addition to the manager, deputy manager, driver, cook and housekeeper. Staff said that extra staffing has always provided if there is a necessity. Issues relating to confidentiality are addressed during the induction period. All records are stored in a lockable office and there was no public display of confidential or personal information. Parkwood House DS0000023988.V343189.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): 12, 13, 15, 16 & 17 People who use the service experience good outcomes in this area. Daily life meets the residents’ lifestyle preferences and expectations. Residents have regular contact with their families and friends. Residents receive a nourishing and balanced diet. This judgement has been made using available evidence including a visit to this service. Parkwood House DS0000023988.V343189.R01.S.doc Version 5.2 Page 13 EVIDENCE: The residents are supported by the staff and manager to help them participate in a range of activities for educational, recreational and therapeutic purposes. Each resident has a weekly programme of activities but the home has to be flexible if residents’ needs change or if residents say that they would rather do something else.. A member of staff said that residents’ activities include bowling, swimming, horse riding, trampolining and going to clubs and discos. Although the home has suitable transport in the form of an adapted minibus, the bus can only take five residents at any one time. The other five residents have to wait until the bus comes back before they can go out. Further, although the minibus has a hoist to enable wheelchairs to be lifted into the bus, the hoist is not usable as it has not yet been tested. One resident who is a wheelchair user requires staff assistance to lower himself out of the bus by easing himself out over a padded mat. Staff said that they are aware that this might compromise someone’s dignity but that there is currently no alternative until the hoist is usable. The care plans contain a list of residents’ needs, likes and dislikes and preferences, and some of this is in pictorial form. Residents may come and go as they please in the communal areas and grounds, subject to risk assessments. The manager and deputy said that risk assessments are reviewed regularly and updated as residents’ needs change. There was evidence in the residents’ daily records to show that families, and other visitors are encouraged and welcomed. One resident said that she was going home soon to see her family and a care manager said how well the home had supported another resident with seeing his family. Although some of the residents have had their finances managed by the home, the systems are in the process of being changed so residents can have access to independent financial appointees. Clear records and receipts are kept for the monies held in personal wallets and individual tins. Staff signatures are required for monies taken out when residents spend money on social activities. These records are all audited regularly as part of monthly Regulation 26 provider’s monitoring visits. Staff said that meals are provided mainly based on residents’ choices, based on what the residents have talked about during their weekly meetings. Staff said that the home also takes into account the need for a wholesome, reasonably balanced diet. The store cupboard contained a wide range of good quality food including fresh fruit and vegetables. The food served at the time of the inspection appeared nutritious and appetising. Parkwood House DS0000023988.V343189.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 & 21 People who use the service experience excellent outcomes in this area. Residents’ choices over their care are respected. Residents’ care plans are reviewed and their health care needs are met. Residents are protected by the home’s policies and procedures for dealing with their medication. Illness and death are addressed with respect and sensitivity. This judgement has been made using available evidence including a visit to this service. Parkwood House DS0000023988.V343189.R01.S.doc Version 5.2 Page 15 EVIDENCE: Residents care plans and daily records refer to monitoring their care, and provide clear guidelines on providing support and monitoring health care and social care needs. There was evidence in residents’ files to show that particular issues have been closely monitored and that they have been referred for specialist help whenever necessary. One resident’s care manager also said how well her client’s needs had been supported. Another resident’s parents confirmed that the manager and staff have been quick to respond to their son’s needs and not only been supportive when he has required help but pro-active in looking for alternative solutions. All of the staff showed a very good understand of the individual needs of residents and there was evidence of staff involvement in the daily recording, care plans and referrals for specialist help. The manager said that new members of staff are referred to care plans as a matter of priority and staff have to sign to acknowledge having read any important guidelines. The home has sound medication procedures and the manager said that these have been updated since the last inspection. Staff confirmed that only trained staff would administer medication and that all staff have to read the procedures stored in the medication file. Systems are in place when medication is taken off the premises such as for day care or home visits. The GP has recorded agreement to the administration of homely remedies as listed and as required and one resident’s family and GP have agreed to the medication being given in a way which suits that resident. Medication records are completed clearly and accurately. The medication is stored securely and appropriately and there are procedures for its receipt and disposal. Parkwood House DS0000023988.V343189.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 People who use the service experience good outcomes in this area. Residents can be confident their complaints will be listened to and dealt with appropriately and that they will be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Although it was difficult to obtain information from some of the residents due to their communication needs, there were several instances during the inspection where residents appeared comfortable telling staff about anything they were not happy with. Staff said that every effort is made to ensure that residents can communicate their feelings if they are not happy with something. The home uses complaints forms that have been produced in a pictorial format. Parkwood House DS0000023988.V343189.R01.S.doc Version 5.2 Page 17 The home has adult abuse procedures in place and staff confirmed that they have received training on adult protection and when and how to intervene in order to safeguard and assist residents. The staff induction process includes information for staff on policies and procedures concerning appropriate behaviour when assisting with personal care, the use of appropriate intervention techniques, and “whistle blowing”. Parkwood House DS0000023988.V343189.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 & 30 People who use the service experience good outcomes in this area. Residents live in a homely,comfortable and safe environment. Residents have all the equipment they require to enable them to be as independent as possible. The home is hygienic and clean. This judgement has been made using available evidence including a visit to this service. Parkwood House DS0000023988.V343189.R01.S.doc Version 5.2 Page 19 EVIDENCE: All bedrooms and living areas are decorated to a reasonable standard, and contain the type of furniture and equipment necessary to provide a homely environment. However some of the furniture, such as the sofas, arm chairs and dining chairs, and some areas of carpet are badly marked and/or are no longer appropriate. Two residents said that they are pleased with their bedrooms and that they had helped to choose colours, furniture etc. Most of the residents have single rooms where they can display their own effects such as posters, models and have their own TV, DVD player etc. There is one shared room which will remain shared until circumstances change as it is the only room which is accessible and suitable for wheelchairs. There is an alarm call system. There are adequate toilets and bathrooms, and there is a specialist bath. There is a well-maintained garden and patio with garden furniture which is used by the residents. There is a large pond in the grounds and a risk assessment has been prepared regarding the resident’s access to it. Staff showed a good awareness of health and safety issues. The home has implemented the actions previously required by an infection control report and all areas were seen to be clean and hygienic. Disposable hand drying towels and pump soap dispensers reduce the risks of cross infection. Staff referred to safe and appropriate ways of disposing of resident’s personal care items. There is separate laundry area which has dual access from the ground floor hallway and the general office. Although some residents may assist in the laundry with staff support, the laundry is not accessible to wheelchair users as there are two steps leading down to it.. There are commercial washers and a drier in the laundry. Maintenance certificates were current and there are no outstanding health and safety requirements. Parkwood House DS0000023988.V343189.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 & 36 People who use the service experience good outcomes in this area. Staffing, in terms of both numbers and competency, is appropriate to the current needs of the residents. Residents are protected by the Home’s sound recruitment procedures. Staff are well trained and supported and morale is high This judgement has been made using available evidence including a visit to this service. Parkwood House DS0000023988.V343189.R01.S.doc Version 5.2 Page 21 EVIDENCE: Staff said that the staffing numbers are adequate to ensure that residents are safe and can participate in their chosen activities. Night staffing also appears adequate and there are emergency on call systems. The staff files included CRB checks on all staff, references and evidence of verbal references. The files also included evidence of induction training, further training and regular recorded supervision. The manager said that just over 50 of staff have NVQ 2 or 3 and that there are several more staff currently working on their NVQ’s. One member of staff said that training since he started has included Adult Protection awareness, Basic Food Hygiene, Fire Safety and the administering of special medication for epilepsy. The staff group has remained stable in the past twelve months and the manager said that residents have benefited from this, eg in providing a stable and consistent environment. Staff referred to the high level of team-work, good morale, and on-going support from the manager and senior staff for work and personal issues affecting their work. Parkwood House DS0000023988.V343189.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 People who use the service experience good outcomes in this area. The home is well run in a manner that encourages the development of clients. There are regular quality assurance and safety checks to ensure that the home is run in the best interests of the clients and their safety and welfare is protected and promoted. All areas are clean, hygienic and well maintained This judgement has been made using available evidence including a visit to this service. Parkwood House DS0000023988.V343189.R01.S.doc Version 5.2 Page 23 EVIDENCE: The manager has extensive experience and recognised care and management qualifications. The management of the home and completion of records are generally of a good standard with daily records regularly checked by the registered manager. There are further checks by the owning company’s area manager as part of the monthly regulation 26 reports. Staff said that the home is run for the residents and that residents are regularly asked for their views and feelings about activities, meals and how things are done. This is either through clients’ group meetings or through the individual talk time for residents. Staff, residents’ families and advocates confirmed that any suggestions or feedback are acted upon. Other quality assurance methods include regular audits and an annual business plan. The manager was very ready to praise the staff team. There were no obvious hazards around the home and there was evidence to show that health and safety issues are taken seriously eg staff ensuring that personal items were appropriately disposed of and warning signs in place for wet floors. The maintenance file contains current certificates to show that regular checks eg gas, electricity, are carried out. Risk assessments on the environment, and for activities off site involving residents, have also been prepared. Parkwood House DS0000023988.V343189.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 4 2 4 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 4 4 X 3 X X 3 X Parkwood House DS0000023988.V343189.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 2 Refer to Standard YA14 YA24 Good Practice Recommendations Provide sufficient transport to enable all residents to participate in activities and ensure that it is fully accessible without the risk of compromising residents’ dignity. Replace worn or soiled carpet and furniture as soon as possible. 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