Care Home: Parkdale

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What the care home does well Parkdale is a small, clean, comfortable and homely place, with a stable, family atmosphere. As far as possible, people living at the service were able to show a positive contribution to the running of the service. This was evidenced in staff recruitment procedures and the internal decoration. One person using the service commented "I like the colour of my room". It was also observed that people had personalised their rooms with appropriate support as required and were reflective of their individual personalities. The staff were directly observed supporting and caring for the people who live at the service. Staff always approached people with care and respect. People were directly seen to respond well to the staff manner and approach. One person commented that "the staff are always nice". People living at Parkdale felt comfortable asking staff for advice or talking about the things that mattered to them. All people surveyed said that they knew how to make a complaint or who to talk to if they were sad. The AQAA tells us that "within the home an open and inclusive environment is created to ensure that daily dialogue is maintained with service users by the staff team to promote regular and honest communication regarding the service provided. This is to ensure that service users feel confident in expressing their views and ideas. These are acted upon continually". One person who uses the service commented, "I like it here, all the staff are lovely". One survey received back commented in relation to what the home does well, "staff caring towards service users". Care planning processes were detailed and evidenced that the people using the service are offered support which is tailored to their individual needs, wishes and preferences. The medication management of the service is to a good standard. With accurate records being maintained and each person having a profile of their medication available. The service has strong links with other support teams ensuring that the diverse and changing needs of individuals are closely monitored and managed in their best interest. One person using the service commented "they help me if I am unwell". The service has a good recruitment process which ensures that staff are recruited following suitable pre employment checks. One person using the service commented "all the staff are good, they help me and are nice". The service has a robust assessment and care planning processes in place that focuses on the individual at all times. Health action plans and care plans are in place to support people`s needs at all times. What has improved since the last inspection? Staffing levels and a consistency of staff has improved since that last inspection. Management systems are being introduced to the service to further support the smooth running of the service in the best interest of the individual. The service user guide and statement of purpose has been updated and improved in terms of access and content for the people using the service. The AQAA has identified that the service is continually improving and that "service users are continuing to gain confidence in expressing their needs, wishes and aspirations regarding all aspects of their life". In addition to this there is a drive for improvement to support "service user participation in day to day tasks around the home and participation in social and leisure activities". What the care home could do better: The service must ensure that the temperature of the location of medications is recorded to ensure that it is being stored as per the manufacturers instructions and guidelines. A date of opening should be added to all bottles, boxes and tubes upon opening and balances of medication brought forward if used from one month to the next. The service would greatly benefit if there was internet and email access for the people using the service, management and staff. The service must ensure that a risk assessment is implemented for the use of and operation of a profiling bed. The current manager must become registered with the Care Quality Commission. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Parkdale 13 Park Road Colchester Essex CO3 3UL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Louise Bushell     Date: 0 9 0 9 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 32 Information about the care home Name of care home: Address: Parkdale 13 Park Road Colchester Essex CO3 3UL 01206769500 Telephone number: Fax number: Email address: Provider web address: www.minstercaregroup.co.uk Name of registered provider(s): Type of registration: Number of places registered: Minster Pathways Limited care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: Persons of either sex, under the age of 65 years, who require care by reason of a learning disability and who may also have a physical disability (not to exceed 6 persons) The manager achieves the RMA qualification by December 2006 The total number of service users accommodated in the home must not exceed 6 persons Two persons, aged 65 years and over, who require care by reason of a learning disability and who may also have a physical disability, whose names have been made known to the Commission Date of last inspection 6 6 Over 65 2 2 Care Homes for Adults (18-65 years) Page 4 of 32 Brief description of the care home Park Dale is a residential care home for adults with a learning disability, who may also have additional physical disabilities. The home does not purport to admit service users who require complex care by way of challenging behaviour. The accommodation is a bungalow arrangement and all bedrooms are for single occupation. There is one lounge/dining room. Care Homes for Adults (18-65 years) Page 5 of 32 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: two star good 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 focus of the inspections undertaken by the Care Quality is upon outcomes for the people who use the service and their views of the service provided. The primary method of inspection used was case tracking which involved selecting a number of people and tracking the care they received through looking at their care records, discussion where possible with the people who use the service, the care staff and observation of care practices. The last key inspection took place on the 31st August 2007. The visit was unannounced and planning for the visit included assessment of the notifications of significant events, which had been received from the service to the Care Quality Commission. We looked at the last Inspection Report and information on safeguarding and Care Homes for Adults (18-65 years) Page 6 of 32 complaints since the last inspection. We also looked at the Annual Quality Assurance Assessment (AQAA) and reviewed what the service has improved in the last twelve months and its plans for the next twelve months. During the visit information was gathered directly from the staff, people who use the service and relatives and or visitors to the service. The visit took place between 9:30am and 14:30pm. This enabled the inspector to directly and indirectly observe the care practices and the day to day operations of the service. A selected tour of the building was conducted during which the inspector spoke with people who use the service, staff and the manager. What the care home does well: What has improved since the last inspection? Staffing levels and a consistency of staff has improved since that last inspection. Care Homes for Adults (18-65 years) Page 8 of 32 Management systems are being introduced to the service to further support the smooth running of the service in the best interest of the individual. The service user guide and statement of purpose has been updated and improved in terms of access and content for the people using the service. The AQAA has identified that the service is continually improving and that service users are continuing to gain confidence in expressing their needs, wishes and aspirations regarding all aspects of their life. In addition to this there is a drive for improvement to support service user participation in day to day tasks around the home and participation in social and leisure activities. What they could do better: 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 set out 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 32 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 32 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. People who use the service can be assured that there needs will be identified through a detailed assessment process, including a visit to the service. Evidence: The service has developed a statement of purpose, which sets out the aims and objectives of the service, and includes a guide, which provides information about the service and the specialist care the service offers. The guide details what the prospective and current individuals can expect and gives a clear account of the specialist services provided, quality of the accommodation, qualifications and experience of staff and how to make a complaint. All new people are given a copy of the guide and the services makes one available for all to view as they wish. On the day of the inspection it was directly observed that this information was available to people using the service, staff and visitors to the service. Three surveys were received from the people who use the service. They all stated that they had enough information regarding the service before they moved in. Two care files were observed of two of the individuals using the service. Assessments tools were observed for both of these people. It was evident that admissions are not made to the service until a full needs Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: assessment has been undertaken. A skilled and trained person always completes the assessment prior to admission to the service. The assessment was detailed and appropriate to the policy and procedure in place. The assessment explored areas of diversity including preferences, religious and cultural needs, involvement from family, partners and advocates, race, gender, age and disability. The service has the capacity to support people who use the service and respond to diverse needs that may have been identified during the assessment process. Information was also gathered from all relevant other professionals in order to ensure that the needs of the person were placed at the centre of the care and support being provided. It was evident on each occasion that essential links had been gained and maintained with, for example the community nursing team and social workers. Surveys returned determined that the care services assessment arrangements ensure that accurate information is gathered and that the right service is planned for people. One person directly commented the manager and staff have created a friendly welcoming home for clients who are resident. All staff are caring. The AQAA tells us that In depth pre-placement assessments were completed looking at all aspects of the individuals life and needs. A detailed and comprehensive report is compiled alongside a care needs assessment which details the assessed needs and how the service will meet these needs. Transitional visits are fully encouraged and planned, this is to offer the individual the support to ensure the transition is smooth and offers the individual support in undertaking a major change within their life. One person who uses the service commented, I like it here, all the staff are really lovely One survey received back commented in relation to what the home does well, excellently managed home for X. The AQAA also identifies that the service is able to highlight its own developmental areas and is stating that over the next twelve months it is aiming to continue to develop and improve the person centred care plans. Continue to develop the preadmission assessment. Individual files also contained a basic practical independence assessment that looks at the aspects of independent living separately from the individual social and emotional needs. The files examined contained the residents copy of their Terms and Conditions that were set out in an easy read format. Care Homes for Adults (18-65 years) Page 12 of 32 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported by a care plan that meets their individual needs and choices ensuring that they are fully supported at all times Evidence: A total of two care plans were case tracked fully. It was established that people who use the service receive personal and healthcare support, which is suitable to meet their needs. Personal healthcare needs including specialist health and dietary requirements are recorded in each persons care plan. The service has a separate health action plan file which contains all the information regarding a persons health care needs. A professional commented all staff are very caring and prompt when reporting any healthcare worries or concerns to the District Nursing Team. The care plan provides information and a guide for staff to know how to support the person. The care plans system in place enables the holistic needs of the person to be presented in a detailed format. The process enables peoples needs to be linked to aspirations and risks. The format is person centred and puts the person at the focus of Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: the care plan. The care plan presented as a working document with regular reviews. These reviews are completed by the key worker and reviewed and checked as part of the internal managers quality assurance system. The care plan is generated from the pre admission assessment and includes guidelines, risk assessments for the management and control of a range of issues, manual handling and where appropriate behavioural support guidelines. The guidelines and care plans are specific to the person and direct the staff on how to meet that specific individual persons needs, wishes and or preferences. An example of this was shown in a persons care plan with regards to their personal communication method and techniques. One person using the service with limited communication was able to comment yes dear, when asked if they liked the staff and the home. The AQAA states that the care plan format has been updated to meet the assessed needs and short and long term goals of all individuals in line with the homes philosophy of care. All individual care plans are written with the service user to identify the health, social and emotional needs in a person centred manner ensuring choices, wishes and aspirations are included. Individuals capacity is assessed following guidelines. Parkdale undertakes full risk assessments regarding identified risks including daily living skills, activities and social activities. Risk assessments are completed giving individuals the opportunities to promote independence and to minimise risks within their lives. Evidence of appropriate risk assessments were seen and reviewed as part of case tracking. It was evident that risk assessments were enabling people to take every day risks as part of developing an independent life style. It was observed that personal support is responsive and tailored to meet the individual choices, needs and preferences. Staff were observed to respect the privacy and dignity of all people. An example of this was seen during the inspection with staff communicating with individuals in a respectful manner and offering them personal hygiene tasks discreetly. In addition to this staff were seen to directly engage with people using their preferred communications techniques and styles. The service listens and responds to individual choices and decisions about who delivers their personal care. People are supported and helped to be independent and can take responsibility for their personal care needs. One person using the service commented they help me the way I like. Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: The AQAA states that The staff team at Parkdale promote a inclusive environment encouraging service users to freely express their needs and choices regarding all aspects of their life. Evidence of this was seen during the inspection. The service has also identified areas of improvements.The AQAA states to further development of the risk assessments and mental capacity of individuals. Further inclusion of the service users with the development of the service. Implement monthly key worker meetings to encourage and enable individuals to implement their own goals they wish to achieve. During the inspection it was directly observed that confidential records were being stored appropriately. Care Homes for Adults (18-65 years) Page 15 of 32 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 who use the service are provided with support to make choices about their lifestyle and to develop their life skills. Evidence: People who use the service are supported to enjoy a full and stimulating lifestyle with a variety of options to choose from. Staff members were able to report that people who use the service were supported to attend various activities, go to the theatre, cinema, shows, and many other appropriate activities. The people who use the service have opportunities at internal meetings to voice their wishes regarding social events and all other issues they wish to discuss. One person using the service commented I like to feed the ducks at the park. On the day of the inspection one person confirmed that they were going on holiday soon with staff and were really looking forward to it. Most of the people who use the Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: service had chosen and arranged their annual holidays with the support of the staff team. The manager confirmed that a range of holidays are being booked this year based on the wishes of the individuals. One person using the service stated that I did all my art work myself, I like going away and eating fish and chips. The service sought the views of the people who use the service and their representatives and considered these when planning the routines of daily living and arranging activities. Routines and activities were flexible and focused around individuals changing needs and choices. Due to the ageing needs of the people who use the service, activities are arranged with a flexible approach for all. Records are maintained where people have engaged in activities. One member of staff commented staff encourage the people we support to enjoy their lives and take part in outings, holidays and events in the community. They always have a choice and are listened to about their point of views. This practice was directly observed during the inspection where staff were observed listening to peoples views and taking action as requested by the individual. The AQAA tells us that the home supports individuals to participate in a fulfilling activity programme including educational, social and community based activities of their choice. The home encourages individuals to access the local community to assist with the developing their social and individual development. Service users are encouraged and supported to attend chosen religious and cultural services and celebrations. Daily routines are flexible and centred around the needs of service users. An inclusive environment encourages services users to express their preferences and choices relating to all aspects of their daily life. The staff team understand the importance of ensuring that all service users are given every opportunity to develop their social, emotional and individual aspirations. One staff member commented we do all we can to get people out and about and encourage them to participate in a range of social activities. It was observed that meals were well balanced and nutritional, catering for the varying choices and dietary needs of the people living at the service. Food stocks were of good quality and in appropriate quantities. The people who use the service selected the weekly menu with the aid of picture books. One person commented I like the food, its nice. A further person nodded their head and smiled when asked if they liked the food. Feedback received from a relative commented meals are appetising and the diet is varied. My X enjoys helping to plan the menus. Healthy eating is encouraged. Care Homes for Adults (18-65 years) Page 17 of 32 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that their health needs are being met in their best interest Evidence: Each person using the service now have separate health care files. These were commenced in May 2009. Each of the files is set in a generic ways and contains all the information specific to the individual regarding their health needs. In addition to this there is a grab sheet. This document is a quick reference guide for the staff to take to appointments and hospitals as required, enabling others to have immediate access to important information. It was identified that the holistic needs of each person using the service was available. The care plans and health needs documentation put the person at the centre of their care. It was evidenced on numerous occasions where different specialists are involved directly with the care and support of the person. Examples of this included community nursing team, outreach services and mental health support services. Records were well maintained. Feedback received from a social and health care professional stated always, in response to peoples social and health care needs being met. The AQAA Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: details information regarding a good practice example of working in the best interests of the person using the service and linking with other multi disciplinary teams. It states personal care is provided in a sensitive and private manner with staff following individual care plans promoting privacy, dignity, choice and independence. All required aids and adaptations are provided for individuals to ensure safety and comfort is provided. Consultations and recommendations are taken from outside professionals including GP, Occupational and physiotherapists. Service users are supported to access all healthcare professionals when required. One person using the service commented they help me if I am unwell. Personal care and support was provided in private and by a person of the same gender where possible. Guidance and support is provided with personal hygiene tasks where required although where people are able to attend to their own personal hygiene needs they were encouraged to do so. Medications were stored appropriately in a locked cupboard. The service operated a system of checking the medication administration routines to further protect the health and well being of the residents. Bottles, tubes and boxs did not have the date of opening added to them. The service did not have a copy of the Royal Pharmaceutical Guidelines in place. Records were well maintained and records were accurate when medication had been stock checked in. The individual person had a medication profile in place which detailed the allergies specific to the person and a picture of the person for staff recognition. Temperatures of the room were not being recorded to ensure that medication was being stored in the correct environmental conditions. The service had a reviewed medication administration policy and procedure in place. The AQAA states, the home uses the Boots monitored Dosage System to ensure the medication needs and requirements of individuals are met professionally and safely. All service users medication is reviewed regularly. All service users have an individual medical profile that Identifies all their identified health needs. Service users have received help and advice from their G.P. with medication. A staff member commented that they had received training in medication. Training records showed that training is offered to all staff regularly updated. Care Homes for Adults (18-65 years) Page 19 of 32 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. People who use the service can be assured that their concerns are listened to and acted upon. Evidence: The service has an open culture, which allows people to express their views and concerns through a variety of methods. Feedback gained from one of the people who uses the service confirmed that they are aware of what to do if they are unhappy and wish or wish to make a complaint. The individual stated, I talk to staff if I am sad, they help me. The service has a clear complaints policy and procedure. The procedure was on display within the service even though there is a service user notice board. A detailed complaints and compliments record is maintained and this is also internally monitored each month and actions clearly recorded. During the inspection there were no recent complaints held on the file. The person in charge reported that any points raised by the people or their representatives were addressed in a timely manner as per the procedure. The AQAA tells us that the home has a complaints policy and procedure. This is made available to everyone who visits or has contact with the home, the complaints procedure is displayed on the visitors notice board. The complaints policy and procedure is in a written format with additional formats in clear simple language and pictorial. The complaints form details to the complainant how the complaint will be hand led including time scales. The home has a comprehensive policy on the Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: Safeguarding of Vulnerable Adults. The staff team receive training in safeguarding and the home ensures that the staff team have a thorough and clear understanding of the subject and the procedure to follow. The service understood the procedure for safeguarding vulnerable adults. Training in the safeguarding and protection of vulnerable people is scheduled periodically and the training has recently been revised in order to incorporate any changes in legislation. The policies and procedures relating to recruitment promotes the safety of the people who use the service through the completion of an enhanced Criminal Records Bureau (CRB) disclosures and two written references before a new staff member starts work at the service. As part of the inspection process a number of staff files were checked to ensure complaince in line with the services policy and procedure. Three staff files were reviewed. One of the staff files contained two references, however one of these references was a verbal reference taken by the manager. This was discussed with the person in charge during the inspection, who stated that a formal response was being returned. All other files contained the required documentation. Time was spent with a new member of staff who was able to discuss their personal experiences of induction and recruitment. The staff member commented I have been completing my induction and having time set aside to read the polices and procedures. When I had an interview they also checked for gaps in my employment, two references and also I had to complete a CRB form. This is further supported by the AQAA which states Staff only begin employment after the home has received all satisfactory checks required by CQC (Care Quality Commission). Staff undertake detailed induction periods, mandatory training and relevant training required to provide a high quality service to all individuals residing within the home. Care Homes for Adults (18-65 years) Page 21 of 32 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 people using the service reside in a suitable, safe, hygienic and homely environment. Evidence: The service continues to be homely, clean, and safe and truly reflects the individuals needs by design and adaptations provided. The people who use the service are fully involved in decisions about the decoration of the service and furniture this includes individual bedrooms and all communal areas. Peoples rooms are very personalised with pictures, and furnishings that the person has been supported in choosing. One person using the service commented I like the colour in my room. Individuals choose to meet with families or friends in communal settings or privately. They also have access to a phone where they can make calls confidentially. Individuals have full access to all facilities, enabling their independence to grow. People using the service made positive comments regarding the environment and one person stated I like my room. A further person expressed satisfaction with the garden area. The AQAA states that the home is a warm, comfortable, homely and clean environment. Furniture, fixtures and fittings are of a good quality. Service users bedrooms are decorated individually with the service users choices and wishes Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: respected. Service users who require specialist equipment and adaptations are fitted after consultation with the relevant professionals, taking into account the service users input and assessed needs. The home has a pleasant garden which is being developed for easier access for service users. Maintenance repairs are dealt with promptly. One person using the service stated, I like it here. A further person communicated their satisfaction by nodding and smiling when asked if they liked the home and their room. The outdoor space available is of a good size and enables people to move around freely. The garden is maintained satisfactorily. On the day of the inspection the person in charge spoke about The service is able to identify areas of continuous development and has highlighted within the AQAA that continue with redecoration programme within the home. Further develop the rear garden to include a sensory area, B.B.Q., bigger patio and new garden furniture. Care Homes for Adults (18-65 years) Page 23 of 32 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service can be assured that their care and support needs are met and are provided by a competent qualified staff team. Evidence: People who use the service have confidence in the staff who care for them. People using the service were relaxed within their own environment and staff were directly observed communicating with individuals in a dignified manner. People using the service feedback in the survey that they feel that the staff and manager treat them well and act upon what they say. Rotas show well thought out and creative ways of making sure that the service is staffed efficiently, with particular attention given to busy times of the day and changing needs of the people who use the service. There are enough staff on duty to meet the needs of the people using the service. The service also operates an on call support system. The AQAA tells us that the home has a trained, motivated, staff team who are enthusiastic and committed to providing the best quality of care to individuals residing at Parkdale. The staff team are committed to promoting individuals independence. Staff have clear and detailed job descriptions that are followed. The home operates using Minster Pathways recruitment policies and procedures that comply with the National Minimum Standards and requirements. Staff Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: only begin employment after the home has received all satisfactory checks required by CQC. Staff undertake detailed induction periods, mandatory training and relevant training required to provide a high quality service to all individuals residing within the home. Staff receive bi monthly supervision. Staff members undertake qualifications. The person in charge encourages and enable this and recognise the benefits of a skilled, trained workforce. Records showed that some staff have completed or are in the process of completing their National Vocational Qualification. Training records showed that there is a structured training plan in place and that all mandatory training needs have been identified and plans in place to provide the training. The system used is effective a identifies any shortfalls. Training is being provided in Deprivation of Liberty and Safeguards as well as the Mental Capacity Act. During the inspection records were seen of the structured induction programme that staff undertake. One staff member commented I have completed my induction, it was very detailed and informative. Feedback received from the staff surveys reflected that staff have information available to them regarding the needs of the individuals and that the induction programme covered the areas of the job that they would be doing. The service indicates in their AQAA that further improvements over the next twelve months include New staff to complete NVQ 2/3. Acting Manager will apply for registration. Further training and development of the staff team. All staff are required to provide satisfactory references and CRB checks before they commence employment. Staff files were reviewed on the day of the inspection and were seen to hold all the required documentation. There is a robust probationary period to ensure that staff is able to achieve the desired level of competency. A comprehensive training and development program is in place which not only addresses the mandatory training needs for new staff but also provides professional and development opportunities for all staff. There is a good recruitment procedure that clearly defines the process to be followed. This procedure is followed in practice with the home recognising the importance of effective recruitment procedures in the delivery of good quality services and for the protection of individuals. Staff recruited confirm that the home was clear about what was involved at all stages and was robust in following its procedure. The AQAA tells us that the people who use the service are involved in the recruitment of staff. One person using the service commented all the staff are good, they help me and are nice. Care Homes for Adults (18-65 years) Page 25 of 32 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that the person in charge has appropriate leadership skills and offers guidance and direction to all staff. This means that the people live in a well managed service. Evidence: Time was spent with the person in charge. This person is currently completing the role as the manager and is to be applying for her registration with the Care Quality Commission. It was clear that the person communicates a clear sense of direction to staff is able to evidence a sound understanding and application of best practice operational systems, particularly in relation to continuous improvement, customer satisfaction, and quality assurance. This was evidenced on the day of the inspection by the people using the service and the staff both making positive comments regarding his leadership and management style. One staff member commented she works with the team and devotes a lot of her time to the home and is exceptional with the clients. In addition to this a further staff member commented she has supported staff in all the needs and is very good. Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: Equality and diversity, human rights and person centred thinking are given priority by the person in charge, who is able to demonstrate a level of understanding and demonstrate best practice in these areas. The AQAA tells us that the home has employed a new acting manager recently who has experience in managing a residential setting. The Acting Manager has obtained RMA and Level 4 qualification. Policies and procedures are reviewed regularly and updated when that current legislation and regulations are included required to ensure. The ethos and leadership style of the service supports and enables people to express their diversity needs including their race, gender, sexuality and age. The manager is able to demonstrate through robust operational systems and professional experience that they are knowledgeable and highly competent in a range of areas. Examples include people being supported and empowered to make personal choices and the documentation of preferences. The person in charge ensures that staff follow the policies and procedures of the service. These are available in the office and were seen to be working documents. The staff are also required to sign each of the guidance and polices once they have read and understood them. There is strong evidence that the ethos of the home is open and transparent. The views of both people who use the service and staff are listened to, and valued. The AQAA contains good information that is fully supported by appropriate evidence. The service demonstrates a good level of self-awareness and recognises the areas that it still needs to improve, and has clearly detailed the innovative ways in which they are planning to do this. The service has efficient systems to ensure effective safeguarding and management of residents money and valuables, including record keeping. People are supported to manage their own money where possible. Those who do not currently have the skills are encouraged and supported to develop to become as independent as possible. They have access to their records whenever they wish. Record keeping is of a good standard. Records are kept securely and staff are aware of the requirements of the Data Protection Act. Risk assessments are in place regarding financial management and risk for all individuals. The service has a comprehensive range of policies and procedures to promote and protect residents and employees health and safety. There is full and clearly written recording of all safety checks and accidents. The person in charge, senior team, and staff at all levels have a good understanding of risk Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: assessment processes which is underpinned by promoting independence, choice and autonomy. These principles are taken into account in all aspects of the running of the service. The person in charge ensures that all staff are trained in health and safety matters. Individual training records reflect this and regular updates are planned ahead. Currently the service does not have access to the internet or email services. This would greatly improve the availability of information for the service, the people using the service and the staff team. Care Homes for Adults (18-65 years) Page 28 of 32 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 29 of 32 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 9 13 A risk assessment must be in place for the use of an electric profiling bed. To ensure that the person using the bed and the staff operating the bed are aware of risks and protected from harm. 10/11/2009 2 19 13 Daily temperatures must be recorded where medication is stored. To ensure that medication is stored in environmental conditions as prescribed by the manufacture. 04/11/2009 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 2 19 19 The service should obtain a copy of the Royal Pharmaceutical Guidelines. A date of opening should be added to all opened bottled, Page 30 of 32 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 boxed and tubed medication. 3 43 The service should consider internet and email access for the people using the service, management and the staff team. 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