Care Home: Parklands Care Centre

What the care home does well We found that the staff were seen to be friendly and pleasant in their manner when they were interacting with the residents. We found that each resdient had a care file in place although attention was still needed to updationg and evaluating the care given in order that staff can provide the appropriate support to meet the residents` needs. We looked around the environment which looked clean. What the care home could do better: Following this visit to the home, from the discussions held with staff and residents and a review of some of the records held we made the following conclusions:The staffing levels and the deployment of staff need to be reviewed and monitored to make sure the assessed needs of the residents are being met in full. The duty rotas should show the hours the home manager is working at the home so the staff are aware of the management support available to them. Records, such as care plan evaluations for areas of risk in relation to nutrition,and mobility and observation charts must be recorded to monitor and evidence that the care as stated in the care plan is actually being carried out. The care plans should inform the staff of the current level of support needed for each person and shortfalls in these records have the potential to put residents at risk of not having their needs met. Records such as standing charts/pressure relief for named individuals should be in place as stated in the care plan to monitor and evidence the assistance and support a resident needs. Residents should be asked about how they like their drinks to be served and food and drink should be served in an appropriate way, for example a cup and saucer and a side plate unless there is an assessed reason why this is not appropriate. Management should ensure that suitable, safe arrangements are made when planned redecoration is made to ensure the safety and well being of the residents. We asked the manager of the home about her application to be the Registered manager with the CSCI, which she stated she had filled in and was now waiting for the company to forward this on. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Parklands Care Centre 67 Broom Lane Salford Manchester M7 4FF two star good service The quality rating for this care home is: The rating was made on: 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. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Elizabeth Holt Date: 1 8 1 2 2 0 0 8 Information about the care home Name of care home: Address: Parklands Care Centre 67 Broom Lane Salford Manchester M7 4FF 01617922020 01617928778 parklandsnh@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Exceler Healthcare Services Limited care home 36 Number of places (if applicable): Under 65 Over 65 15 21 dementia old age, not falling within any other category Conditions of registration: 15 0 A maximum of 36 residents may be accommodated aged 65 years or over. A maximum of 21 residents may be accommodated who require care by reason of old age (OP). A maximum of 15 service users aged 50 years or over with dementia (DE), (DE(E) ) may be accommodated within the overall numbers Date of last inspection Brief description of the care home Parklands Care Centre is a care home providing nursing and personal care for 40 residents. There are 36 single bedrooms and 2 twin bedded rooms situated on three floors. Care Homes for Older People Page 2 of 11 Brief description of the care home The residents accommodated at the home are mainly of the Jewish faith and all Jewish traditions are observed. A Shomer is employed as part of the staff team to offer guidance and support to the other members regarding religious practices and cultural observations. A full Kosher menu is provided. The home is located off a main road in a quiet residential area of Salford with car parking located at the front of the building. There is a small garden area to the front and a terraced patio area to the rear of the home. The weekly fees range from 480 to 500 pounds per week. Additional charges are made for hairdressing and newspapers. The home has a statement of purpose and service user guide, available on request. Care Homes for Older People Page 3 of 11 What we found: The reason for our visit to Parklands was to carry out a random inspection looking specifically at the staffing and management arrangements to make sure the home was suitably staffed to meet the needs of the people living there. We also checked that the manager of the home had addressed the requirements we made at our last visit. In the period since the last key inspection on the 18th June 2008, concerns were made in relation to two named people including an allegation made under Adult Safeguarding procedures and concerns in relation to staffing levels were made from a person who chose to remain anonymous. The visit was unannounced as the manager and staff did not know we were going to visit. The visit started at 13:30 and finished at 17:15 on the 18th December 2009. The visit involved one inspector only and focused on checking that the home was being suitably staffed to meet the needs of the residents in particular on the first floor, the dementia care unit. The purpose of the visit was stated to the home manager at 13.40 when we arrived. During our visit we spoke to the home manager, the unit manager on the first floor (EMI unit), the activities organizer, care workers, people living at the home and a visitor to the home. Feedback was given to the Operations Manager and the manager at the end of the visit. We made a visit to the first floor where the unit manager was on her own with the responsibility for the six residents accommodated at the time. The unit manager said that the care worker who usually worked on the first floor was attending training in challenging behaviour which had left her with minimal support on the day of this visit. Discussions with the manager and other staff highlighted that The floater who was the care worker allocated to support this unit, was regularly pulled away from the first floor to work downstairs. When asked about the support to meet the residents needs the unit manager had received on the day of the visit we were told the following; The care worker had assisted during breakfast time. Yesterday I got my lunch at 3pm and I have not had my lunch yet today and it is ten to two. I had supported everyone to get up on my own today. I manage to give out medication whilst residents are eating their breakfast. A brief conversation with the care worker who had been the floater on the previous day stated she had not been able to give much support to the unit yesterday as she had been on a hospital appointment with another resident and therefore not on the premises. A discussion was held about the needs of some of the individual residents which highlighted some of these residents need the support of two staff members during the day in order to have their needs met in full. A look at the duty rotas for the weeks commencing the 8th December 2008, 15th December 2008 and the 22nd December 2008 showed there were regularly two staff allocated to the first floor however discussions with the staff and comments from a visitor and from the concerns raised showed this staff member tended to be a floaterand spent time running between the floors. The duty rota for the 18th December 2008 , the day of this visit showed there were two staff for the nursing floor and two staff allocated for the first floor from 8.00am-2.00pm and from 2.00pm -8.00pm. The care worker who was supporting the registered nurse on the ground floor on the day of this visit said she had been popping up and downstairs during the Care Homes for Older People Page 4 of 11 morning. In house training was also being provided on this day. It is questionable whether the care provided by staff popping up and downstairs is sufficient to meet the needs of residents with a dementia type illness due to the need to establish trusting relationships and the time needed to support a person. A discussion with the staff showed that the use of agency and bank staff sometimes made it difficult as they did not know the residents well in order to meet their needs. The rotas did not show the hours worked by the homes manager, which did not show the management support the staff were receiving and a recommendation was made to address this and include the mangers hours on the duty rota. Time was spent sitting in the lounge areas during this visit and observations made included one of the residents cardigan buttons were all fastened in the wrong places, her top was noticeably stained, hair was uncombed and the resident had no shoes or slippers on their feet. A number of residents were seen to have unclean finger nails and chipped nail polish in place. Residents were given a cup of tea in the afternoon and this was served in a cup without a saucer and biscuits were placed on the table alongside the resident. One resident stated, There is too much sugar in this to which another resident said, They always put it in whether or not. During this visit three care plans and risk assessments were briefly looked at. The resident to whom the care plans belonged to was observed or spoken to where possible. One resident had a risk assessment in place for falls and her support plan showed she was dependent upon two care workers to mobilize and assist back to her bedroom. The evaluation which had last been filled in stated that ... is on an observation chart for her stands. We need to keep...on the move. Do not let her sit too long. Aim is to get her back to independent walking. This evaluation had not been updated since 17/10/08 to show how she was currently doing. The staff could not find an observation chart for the residents standing. The care plan showed this person needs the support of two staff to meet her hygiene needs and a record in November 2008 showed she had two pressure sores. The unit manager did say she has started some of the monthly evaluations for the six residents accommodated but she had not yet finished these. During this visit this person was clearly in need of support from staff who knew her needs. One of the visitors on the unit at the time spent time distracting this person and chatting to them. By not reviewing and evaluating the care needs of the residents accommodated and updating the care plans, there is the chance that residents needs may not be met. The care plan for another resident who was visited in her bedroom showed this person needed to be interacted with as much as possible. This resident needed the support of two staff to assist her to the bathroom and to her wheelchair. Due this persons medical and psychological state the unit manager recognized this resident needed regular monitoring. The care plan for this resident showed they need encouragement to mobilize, to come out of their room more often and to join other residents in the dining room at mealtimes. This resident was seen to be in a poor state of personal care, their bed was soiled, their hygiene needs needed some support, their hair was untidy. The manager was in agreement this resident was in need of support immediately and assistance was requested from the care worker on the ground floor straight away. It was recognised the management had received appropriate professional advice during the course of the day for this resident whom they had recognised needed some further professional input. The impact of not meeting the residents needs in full was discussed with the senior manager and home manager. It was evident that the senior manager recognised there was a deployment of staff issue Care Homes for Older People Page 5 of 11 and she stated that there was a new senior staff member due to start at the home on the 22nd December 2008. Arrangements must be reviewed for the staffing of the home to ensure the staff can meet the needs of the residents accommodated. A sample of medication adminstration charts were looked at which showed these to be appropriately filled in on the day of the visit. We were told of an incident recently which has affected the staff morale on the unit, due to the number of residents accommodated being low in the home, a decision was made to move residents where possible to bedrooms on the ground floor. This clearly distressed some of the residents possibly due to the unfamiliar environment, a change of staff and unfamiliar residents. A look at the incident records showed that two of the residents had been aggressive due to changes in moving floors. Staff had managed this by supporting residents to move back to their original bedrooms. On the day of this visit there were workmen in place painting the walls of the corridors. Some of the residents were unable to access their bedrooms because of the work being done and as this was the holiday period it was unlikely to have been fully decorated during this time. A discussion with the manager highlighted the need to manage this situation to their best however some residents were unable to access their bedrooms due to the equipment outside their rooms. Although comments from staff were positive that residents were gradually calming down now they had returned to the first floor this had clearly caused considerable distress to some residents, relatives and staff. Management should ensure that suitable, safe arrangements are made when planned redecoration is made to ensure the safety and well being of the residents. A discussion was held with the activities organiser who said she worked between the hours of 10-12 five days a week. It was clear she had been working hard to provide and support residents to join in some activities and parties. On the day of this visit she stated that she had been unable to see residents on the first floor because training had been held. She stated she had spent approximately one hour with the residents the previous day and she said the residents needed one to one attention for support with activities which was sometimes difficult due to time constraints. On the day of this visit there was no evidence to show that any of the residents on the first floor were encouraged to join in any social care activities and some of the residents observed were seen to be in need of some support, diversional and or recreational activities. What the care home does well: What they could do better: Following this visit to the home, from the discussions held with staff and residents and a review of some of the records held we made the following conclusions: Care Homes for Older People Page 6 of 11 The staffing levels and the deployment of staff need to be reviewed and monitored to make sure the assessed needs of the residents are being met in full. The duty rotas should show the hours the home manager is working at the home so the staff are aware of the management support available to them. Records, such as care plan evaluations for areas of risk in relation to nutrition,and mobility and observation charts must be recorded to monitor and evidence that the care as stated in the care plan is actually being carried out. The care plans should inform the staff of the current level of support needed for each person and shortfalls in these records have the potential to put residents at risk of not having their needs met. Records such as standing charts/pressure relief for named individuals should be in place as stated in the care plan to monitor and evidence the assistance and support a resident needs. Residents should be asked about how they like their drinks to be served and food and drink should be served in an appropriate way, for example a cup and saucer and a side plate unless there is an assessed reason why this is not appropriate. Management should ensure that suitable, safe arrangements are made when planned redecoration is made to ensure the safety and well being of the residents. We asked the manager of the home about her application to be the Registered manager with the CSCI, which she stated she had filled in and was now waiting for the company to forward this on. 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 2. Care Homes for Older People Page 7 of 11 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 11 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 8 13 Records, such as care plan 30/03/2009 evaluations for areas of risk in relation to nutrition, mobility and observation charts must be recorded to monitor and evidence that the care as stated in the care plan is actually being carried out. Failure to review and address the changing needs of residents puts residents at risk of not having their health, personal or socail care needs met. 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 It is recommended the number and deployment of staff is monitored and reviewed to make sure there are enough staff for the residents to receive appropriate care to have their care needs met in full. It is recommended the range of activities provided is reviewed and increased to better meet peoples social care needs. 2 12 Care Homes for Older People Page 9 of 11 3 15 A record of the individuals likes and dislikes in relation to their fluids should be made to show their personal preferences are being met. The duty rotas should show the hours the home manager is working at the home so the staff are aware for the management support available to them. 4 27 Care Homes for Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. 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