Care Home: Parklands

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What the care home does well The service at Parklands is relatively small and intimate and is based on what people living in the home want and need. The home is comfortable and welcoming. Recent quality assurance surveys evidenced comments made by people receiving a service at Parklands and included.....We are one big happy family. And.....Its like Home from Home. Residents are supported to be as independent as they can and to keep in touch with their family and friends. They have access to a range of meaningful daily activities and leisure pursuits. The manager, provider and staff evidenced a good understanding of resident`s individual needs and respected their choices and decisions. Meals are varied and offer choice, ensuring people living there receive a balanced and nutritious diet. Services that provide social care must be sensitive to people of different cultures, age, gender, faith, disability and sexuality. Throughout the service, there was evidence of a good awareness and understanding of equality and diversity issues, which translated into positive outcomes for residents. What has improved since the last inspection? All three statutory requirements issued as a result of the last inspection have been addressed. The service user`s guide was in need of review to ensure it accurately reflected amendments to the Care Homes Regulations in relation to fee charges. This has largely been resolved and only minor adjustments remain outstanding to ensure people have all the information they require about living at Parklands. The home`s recruitment practices have improved to better support and protect residents from any potential for harm. Staff files now all evidence proof of identity and a recent photograph of each employee, as legislation demands. National Minimum Standards require the home to evidence that over 50% of staff employed are NVQ qualified at level 2. The home now exceeds this percentage and more staff are undertaking NVQ qualifications to ensure residents` needs are consistently met by appropriately trained staff. What the care home could do better: Resident care plans and contracts should be provided in a more accessible person centred format in terms of language and use of visual images and symbols to better suit the needs of the individual for whom they are intended. Risk assessments designed to eliminate or reduce hazards in the care and support of residents should be reviewed to ensure they provide sufficient detailed information to sufficiently guide and direct care staff. The bin in the visitor`s toilet is not foot pedal operated as good practice demands. It is recommended that this is replaced to ensure the home`s infection control measures are not compromised and the use of hard soap left in communal areas is reviewed to protect service users from any potential for harm. Consideration should be given to the further development of the home`s quality assurance systems to better evidence good practice. Sound management practice suggests that the home`s completed AQAA should contain excellent information that is fully supported by appropriate evidence. The data section also needs to be accurately and fully completed and supports the evidence provided in the self-assessment section. Key inspection report Care homes for adults (18-65 years) Name: Address: Parklands 7 Eldersley Close Redhill Surrey RH1 2AJ     The quality rating for this care home is:   three star excellent 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: Marion Weller     Date: 2 7 0 1 2 0 1 0 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 29 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 29 Information about the care home Name of care home: Address: Parklands 7 Eldersley Close Redhill Surrey RH1 2AJ 01737765179 01737765179 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Mary Frances Philpot care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 5. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Parklands is a care home providing personal care for up to 5 adults with learning disabilities of either gender. The home is situated in a quiet residential area within walking distance of Redhill Town centre. A wide range of shops and other community amenities are close by including a leisure centre, cinemas and theatre. The home is also well served by public transport. Accommodation at the home is domestic in scale and character and is arranged over the one level of a modern detached bungalow. All service user bedrooms are for single occupancy. Two rooms share an en suite bathroom. There is aso a communal bathroom, kitchen, utility room, office and a comfortable lounge/dining room. The lounge door opens onto an elevated furnished terrace with steps down to a mature and attractive enclosed garden. Alternative access Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 5 Brief description of the care home to the rear garden is available through a side gate that is visible from the front garden path. Weekly fee charges are £850 to £1500 according to assessed personal need. Additional costs that service users have to meet include hairdressing, toiletries, magazines, some activities, transport and holidays. The service offers respite care when accommodation is available. Please speak to the registered manager for more information. Care Homes for Adults (18-65 years) Page 5 of 29 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: three star excellent 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 inspector, who was unaccompanied during the site visit, arrived at the service on the 27th January 2010 at 10:45 am and was in the home for four and a half hours. Contact was made with the manager a short while before this visit in order to establish when the home would be staffed to facilitate access. During the site visit the inspector spoke briefly with a member of the support staff and one of the resident group. The remainder of the resident group were not at home during the site visit. The inspector spoke at length with the provider and the registered manager. A number of documents relating to service users were sampled including care plans, risk assessments and medication records. Two staff files, including recruitment and training records were checked and documents and reports relating to the homes quality assurance were viewed. The inspection report takes into account all the information obtained about the service. This includes any formal notifications, reports, phone calls and letters received and any Care Homes for Adults (18-65 years) Page 6 of 29 information concerning complaints or allegations. The manager was asked to complete the homes Annual Quality Assurance Assessment (AQAA) prior to the inspection. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gives some numerical information about the service. The completed document gave us information which provided a reasonable but limited picture of what was happening in the service, and their plans for further development. During the site visit the inspector looked at how well the service was meeting the standards set by government and has, in this report, made a judgement about the standard of service provided by the home. There were no legal requirements made as a result of the inspection. The home has substantial strengths and a sustained track record of delivering good performance and managing improvement. Where areas for improvement emerged as a result of the inspection the provider and the manager recognised them and spoke of their commitment to manage the necessary changes. The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Resident care plans and contracts should be provided in a more accessible person centred format in terms of language and use of visual images and symbols to better suit the needs of the individual for whom they are intended. Risk assessments designed to eliminate or reduce hazards in the care and support of Care Homes for Adults (18-65 years) Page 8 of 29 residents should be reviewed to ensure they provide sufficient detailed information to sufficiently guide and direct care staff. The bin in the visitors toilet is not foot pedal operated as good practice demands. It is recommended that this is replaced to ensure the homes infection control measures are not compromised and the use of hard soap left in communal areas is reviewed to protect service users from any potential for harm. Consideration should be given to the further development of the homes quality assurance systems to better evidence good practice. Sound management practice suggests that the homes completed AQAA should contain excellent information that is fully supported by appropriate evidence. The data section also needs to be accurately and fully completed and supports the evidence provided in the self-assessment section. 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 29 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 29 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. Prospective residents and their representatives would have access to the information they need to enable them to make an informed decision about using the service. Some minor amendment would ensure this is comprehensive and produced in a style that met individual need. People moving to the home would have a full assessment of their needs before they are offered a place at the home. Evidence: The home has an up to date Statement of Purpose and Service User Guide. People living at Parklands are provided with their own copy of the Service User Guide in a user friendly version. At the last inspection a requirement was issued for the manager to review the guide and include additional information about fee charges in accordance with recent amendments to the Care Homes Regulations. The guide viewed on this inspection had been revised. Further minor amendment was discussed and written guidance for the manager to follow provided. The manager spoke of his firm intention to resolve this matter. Residents have an individual contract on their personal file. A good practice suggestion Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: was made that these be developed in a more accessible format in terms of language and use of visual images and symbols to better suit the needs of the individual. Since the last inspection the registered provider has made application to increase the homes registered numbers to 5 residents. There have however been no further permanent admissions to the home. The three existing residents have been living there for several years. The manager described the assessment process they would follow for anyone new moving into the home. The explanation clearly followed good practice guidance. The assessment of need undertaken for two of the people already living at Parklands was seen and covered all the areas of support they needed. Assessments had been updated regularly as part of the homes care plan review process. Care Homes for Adults (18-65 years) Page 12 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are involved in decisions made about their lives, and play an active role in planning the care and support they receive. Evidence: Each person has an individual plan of care. Two plans were inspected at this site visit. They showed that the resident, their relatives and representatives had been consulted and involved in the formulation of the plan and that content was based on the persons full assessment of need. Where possible they were signed by the individual involved to evidence their involvement and agreement with the plan of care. Care Plans were comprehensive, detailed documents and covered all aspects of the persons personal, social, and emotional needs. Records show that reviews take place regularly and care plans are amended when necessary. Funding authorities review care placements annually. The manager said they encourage relatives and other people who matter to the person to be involved in care planning meetings and Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: reviews. Observation showed that staff on duty were knowledgeable about residents choices and views and skilled in ensuring they were being met. Each service user has a named keyworker who works closely with them. In discussion, a resident evidenced high levels of satisfaction with the service and was clearly involved in all aspects of life in the home. It was discussed with the provider and manager that good practice suggests that the homes current care plan format could be further developed to enhance peoples accessibility to it by the use of symbols, photographs and pictures. The manager said this is work is in progress. Residents are being supported to make decisions about their lives and enabled to have appropriate control, with assistance where necessary. Any restrictions to their choices are managed through their individual plan of care and risk assessments, which are updated regularly. The risk assessments viewed are designed to adequately secure the individuals welfare and safety. It was discussed that service users may benefit further by adding detail for staff about how they reduce or eliminate the hazards identified. Risk assessments seen tended to identify hazards well, but failed on occasions to provide sufficient detail to adequately inform and direct staff. The manager and provider spoke of their intention to review all risk assessments in line with good practice advice. Care Homes for Adults (18-65 years) Page 14 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are supported to lead busy and interesting lives that meet there social, educational and leisure needs. They are supported to identify and undertake their responsibilities in the home and their rights to privacy and personal space are respected. A varied and nutritious menu is available and people are supported to choose the meals they enjoy. Evidence: Residents are encouraged and supported to be as independent as possible and to make choices about how they spend their time. Records show there is ample opportunity for them to engage in appropriate educational and recreational activities. For example, attendance at social education centres and colleges were arranged Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: where they could develop life skills, improve their literacy and numeracy and socialise with peers. Care documentation records that all three residents had supportive families with whom they spent time on a regular basis. A resident related to the inspector how much they had enjoyed a holiday to Disney World Paris recently. The homes AQAA records....we are conscious that residents want to live lives as full and independent as possible. To this end we organise all kinds of activities. Some in the home; some in the local area; some in London; and some much further afield. These activities are not necessarily things in which everyone takes part, sometimes that is the case; sometimes the activity suits only one individual, in which case they are supported individually to do it. The home provides transport facilities to take residents out in the community. People living there are also encouraged to use public transport and to walk to events arranged locally. Routines of daily living were observed to be flexible and take into account the varied lifestyles of each person living at the home. The provider said service users help as much as they are able with the chores around the house and have access to all communal parts of the home. Residents privacy in their own bedrooms is respected by staff and they are offered their own door key to their rooms. Bedrooms viewed were comfortable and had been personalised by the occupant. Visitors are welcome in the home. The manager records......Family members take advantage of the open house atmosphere at Parklands. We encourage them to treat Parklands as the home of a relative and so they visit any time without having to make appointments. The arrangements for safeguarding residents personal finances remain consistent with our records. Residents have building society accounts and family members have appointee responsibilities. Hand-over procedures between staff include checks on money held for safekeeping on the residents behalf. The provider said that residents had access to their bank accounts and staff supported them with budgeting and overseeing withdrawals from accounts as necessary. Residents choose what they wish to eat and they are supported in purchasing food and preparing meals in the home. They are able to eat informally at a table in the kitchen. Records are kept of food eaten by residents to ensure their diet and nutritional needs are constantly monitored. It was apparent from observation that individuals are well supported by staff to enjoy their meals and mealtimes in a friendly and homely atmosphere. Care Homes for Adults (18-65 years) Page 16 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service have their personal and health care needs met in the way they prefer and they are supported to be as self managing as possible. The management of medication is satisfactory. Evidence: Residents personal care needs are outlined in individual care plans. Health action plans have now been fully introduced with the help of the residents GP, as recommended in the Valuing People white paper. This supports people to identify their own health needs in a holistic way and gives them more control over managing this aspect of their lives. Residents are encouraged to be as self managing as possible. Staff are aware of individual support plans and therefore residents receive personal care and support in the way they prefer and want. The manager records in his AQAA.....Dignity and privacy are the most important watchwords in this outcome area and we observe these and ensure that every action taken ensures they are respected. All residents are registered with the same local GP and attend the surgery for appointments when Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: required. Health records show that appointments are made and records of outcomes are being maintained regarding health professionals involvement with residents. Residents visit a local dentist and Optician regularly. Our records also show that residents wishes are sensitively explored in relation to ageing, sudden illness and death. People are supported to dress in the way that promotes their self esteem and expresses their identity and are supported to purchase their own clothes. Guidance and support from staff about healthy eating choices are encouraged and menus regularly include fresh fruit and vegetables. The provider spoke of resident who was endeavouring to follow a healthy eating plan as they were prone to putting on weight. The resident was supported in her efforts by her key worker. Staff supported service users to engage in various healthy leisure pursuits and the manager said residents regularly went swimming and walking. Medication administration at Parklands remains unchanged from the last inspection. There is a policy in place for the administration of medication and all staff has training in this and undergo regular competency assessments. The manager spoke of introducing a consistent monitored dosage system for all residents. Dispensing of residents medication is currently rather fragmented. Medication charts were seen to be well maintained. The home does not provide a separate medication fridge for the cold storage of medication. It was suggested to the manager that this situation is risk assessed, after seeking guidance. The Royal Pharmaceutical Society of Great Britain launched new guidance on handling medicines in social care settings in November 2007. It replaces their previous publication The Administration and Control of Medicines in Care Homes and Childrens Services. Care Homes for Adults (18-65 years) Page 18 of 29 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 using this service know how to make a complaint if they need to and can be assured their concerns will be taken seriously. They would benefit from records of discussions and agreements at residents meetings being produced to meet individual need for future reference. Residents are safeguarded in the home from harm and abuse. Evidence: The home has strategies in place to ensure that those who live there and those that visit can make their views and complaints known. The home records that no formal complaints have been received over the last year and minor concerns are always dealt with quickly. Our records indicate that there have been no complaints sent to the CQC about this care home. The complaint procedure is made available to residents and has been produced in a pictorial format to meet individual need. Regular residents meetings take place where issues of concern can be openly discussed and resolved. Although notes of meeting outcomes are recorded, they should also be produced in a format which is better suited to the individual needs of each resident. There is a safeguarding adults policy in place and all staff undertake training in adult protection issues during induction. There are elements of adult safeguarding included Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: in staff NVQ qualifications. People spoken to were aware of safeguarding procedures and what action to take if they suspected abuse was happening. There is a copy of Surreys Multi - Agency Policies and Procedures for the Safeguarding of Vulnerable Adults in the home dated 2008. The provider and manager have attended the local authority training in safeguarding procedures and have cascaded awareness throughout the staff team. Mandatory training for staff is also regularly arranged and updated. Evidence further shows that robust recruitment procedures ensure service users are protected in the home. Care Homes for Adults (18-65 years) Page 20 of 29 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. Residents live in a comfortable, safe and homely environment that meets their needs. The home was clean, hygienic and overall designed to maximise independence. Evidence: The accommodation at Parklands presents as homely and welcoming. The bungalow is being maintained and is attractively decorated throughout. Communal areas and a number of service users bedrooms were viewed and found to be bright, airy and comfortable. Bedrooms reflected the personality and interests of the occupant and had sufficient space to display personal possessions, store clothing, sit and relax and provided service users with a comfortable bed. The homes AQAA records.....we have continued to maintain and, where possible, enhance the environment. Over the next 12 months we will be undertaking redecoration of the hall and renewing some furnishings. The premises were well lit, clean and odour free with attention being paid to infection control measures designed to protect service users, visitors and staff from harm. The bin in the visitors toilet is not foot operated however. It is recommended that this is replaced to ensure the homes infection control measures are not compromised. It was noted that the provider had laid a new wooden floor in a residents room to meet the persons ongoing personal and health care needs. This is clearly beneficial and Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: evidences the homes ability to respond appropriately to individual need. Information received prior to the visit indicated that safety and maintenance certificates and checks are in good order and up to date. The homes AQAA also records....We have installed nine new fire doors in the last 12 months to keep up with fire regulations. A secondary heater in a residents bedroom and noted in the text of a previous report has been removed to eliminate the risk of burns from the hot surface temperature. Care Homes for Adults (18-65 years) Page 22 of 29 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. Residents benefit from a competent and qualified staff team who are properly supervised in their work. Residents are further supported and protected by the homes recruitment policy and practices. Evidence: Two staff files were seen on this site visit. They contained all the necessary documentation to evidence that appropriate checks had been made before employing people to work in the home. This included obtaining two written references, a health check, POVA first check and an enhanced criminal records bureau check. All staff completes an application form, stating their job history. The manager ensures there are no gaps in employment that are left unexplained and staff then undergo an interview. A statutory requirement was issued at the last inspection to ensure staff files evidence proof of the employees identity and a recent photograph of the individual. This has now been addressed. As National Minimum Standards demand, the home evidences that over 50 of staff employed are NVQ qualified, at either levels 2 or 3. Staff training records evidence that staff have completed mandatory training courses to enable them to carry out their roles safely and to meet the specific care and health needs of people living in the Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: home. Normal staffing levels are one or two staff on each shift during day time hours. Deployment of staff during the day is dependent on the activities planned. Staffing levels appear adequate. Vacant roster hours are generally covered by agency staff. The manager spoke of asking for the same agency staff on each occasion to ensure continuity of care for the resident group. At night one sleeping in member of staff is available. This member of staff has direct access to the provider and the manager at all times. The home does not provide dedicated sleeping accommodation for staff. At the time of the inspection sleeping in staff were useing a vacant bedroom. The manager and provider said that staff have regular supervision and records evidence supervision covers many areas of their work, practice and responsibilities in the home. The manager explained that supervision sessions and staff meetings are also used as a means of updating staff with any changes in legislation and good practice guidance. The manager spoke particularly about arranging that he and the staff receive training in The Mental Capacity Act 2005 and Deprivation of Liberty Safeguards during the next year. Care Homes for Adults (18-65 years) Page 24 of 29 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. The arrangements for management and administration ensure the home is run in the best interests of residents, and their health and safety is promoted and safeguarded. Quality assurance and quality monitoring systems exist but could be further developed to better evidence the homes good practice. Evidence: The registered manager has worked at Parklands for a number of years and demonstrated a good understanding and insight into the individual needs of the people living in the home. Our records show the manager to be suitably qualified and sufficiently knowledgeable to run the home on a day to day basis. It was clear that he and the provider have the best interests of service users at the core of service delivery and communication between them was regular and effective. The manager records in his AQAA....Parklands is an open, inclusive home whose only aim is to enhance the lives and environment of those who live there. Quality assurance surveys are sent out to stakeholders in the service regularly. The Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: most recent surveys were completed in October and December 2009. These clearly showed that people are happy and content with the service they receive. Comments included....We are one big happy family. And. .....Its like Home from Home. The provider ensures compliance with statutory provider visits. Recent reports generated from these visits were viewed. Other methods of auditing quality standards were evident, such as regular meetings and placement reviews with residents, their relatives and holding staff meetings. The benefits of further developing the homes quality assurance systems were discussed to ensure the home can better evidence their good practice. Feedback was also given to the manager in relation to the homes AQAA return to CQC. The manager fully understands the importance of the AQAA but should consider developing the content of each completed outcome area to ensure they fully reflect the national minimum standards that fall within them. Good practice suggests that the AQAA should contain excellent information that is fully supported by appropriate evidence. The data section also needs to be accurately and fully completed and supports the evidence provided in the self-assessment section. Relevant risk assessments have been completed for the home and a fire risk assessment is in place. There were no significant issues regarding health and safety, although it was recommended that bins for the disposal of paper hand towels are foot operated and that hard soap in communal areas is not sanctioned to ensure the homes infection control policy is not compromised. In relation to The Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. There is no one living in the home who is the subject of a deprivation of liberty authorisation. Care Homes for Adults (18-65 years) Page 26 of 29 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 29 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 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 Care Homes for Adults (18-65 years) Page 28 of 29 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). 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. 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