Care Home: Parklands Care Home

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What the care home does well Service users’ needs are fully assessed before they move into the home. This is important to ensure that Parklands is able to meet their health and personal care needs. Service users are treated with dignity and respect and relatives and friends can visit anytime they want to. There are good activities which include trips out shopping, film shows, and table top cooking. The food is good with plenty of choices. There is a good complaints procedure in place so that people know their views will be listened too. The home is clean. Many of the care staff have completed the NVQ level 2 qualification in care. And the manager knows what other training staff need, for example training in dementia, and has a training programme in place to address this. The manager has many years experience of managing a care home as a deputy manager. There are good quality assurance systems in place to help make sure care standards are maintained in the home. Service users said: "its great" "I know everybody in here" "its always clean" "its top of the pops" "its a lovely building" and "the meals are beautiful" .Relatives said: "staff are brilliant" "I`m over the moon XXXX is in here" and "they get good meals". What has improved since the last inspection? There were no requirements or recommendations made at the last inspection. What the care home could do better: Care plans need to include more information about the service user’s health and social care needs. This will help to ensure they receive care and support in a way that they prefer. The manager needs to obtain a copy of the local authority safeguarding procedure so that staff know when to refer incidents to the local authority. This is important to ensure that service users are fully protected. The environment needs to be adapted to help people with dementia. For example, there should be bright contrasting coloured toilet seats and grab rails so they can be easily seen and plenty of signs in different formats to help people find their way around. The manager needs to find out about best practice in dementia care to help her to improve the environment. Many doors are kept locked in the unit for people with more dementia. This is not good practice as it prevents people with dementia choosing where they would like to spend their day. Since we did this inspection the proprietor asked to meet with us to tell us about the action taken to address the above issues. We met with the proprietor and manager at Parklands on the 3rd July 2009. It was evident from this meeting that much work has been undertaken to address the above issues. We looked again at the care plans and these were much more detailed. Bedroom doors are no longer kept locked and there have been some changes to the environment to help people with dementia find their way around. The manager has also obtained a copy of the local authority safeguarding procedure. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Parklands Care Home Station Road Seaham Durham SR7OAD The quality rating for this care home is: Two star good 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 assessment of the service. We call this full assessment a ‘key’ inspection. Lead inspector: Nic Shaw 3 0 0 1 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. They reflect the things that people have said are important to them: 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 older people 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 Older People Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Parklands Care Home Station Road Seaham Durham SR70AD Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration Category(ies): Dementia Old age, not falling within any other category Physical disability Additional conditions: The maximum number o service users who can be accommodated is 71 Date of last inspection: Brief description of the care home: Parklands is a 71-bedded single storey home. Accommodation is provided for people requiring nursing or residential on a permanent or respite basis. It is situated in its own grounds close to Seaham town centre. Parklands comprises of 3 self contained units, West Park Court accommodating young physically disabled service users, East Park Court accommodating elderly service users who require nursing or residential care and Penshaw Court for elderly service users who have mental health problems. The home is surrounded by well-maintained gardens and has ample car parking space available for visitors. The range of fees charged are from £390.50 to £581.63 per week. Care Homes for Older People Page 4 of 23 01915130150 01915130626 Parklands1@aol.com Searchplace Limited Liz Lonsdale Care home 71 Number of places (if applicable): Under 65 0 0 29 Over 65 18 24 0 0 6 0 2 2 0 0 8 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 How we did our inspection: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations-but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Before the inspection visit: We looked at: Information we have received since the last annual service review on the 6th February 2008. How the service has dealt with any complaints and concerns since the last visit. Any changes to how the service is run. The providers view of how well they care for people. Care Homes for Older People Page 5 of 23 The visit: An announced visit was made on 30th January 2009. During this visit we: Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had knowledge, skills and training to meet the needs of the people they care for. Had a look around the home. Talked to service users, staff and visitors. Checked what improvements had been made since the last visit. We told the manager what we found at the end of the visit. Care Homes for Older People Page 6 of 23 What the care home does well: Service users’ needs are fully assessed before they move into the home. This is important to ensure that Parklands is able to meet their health and personal care needs. Service users are treated with dignity and respect and relatives and friends can visit anytime they want to. There are good activities which include trips out shopping, film shows, and table top cooking. The food is good with plenty of choices. There is a good complaints procedure in place so that people know their views will be listened too. The home is clean. Many of the care staff have completed the NVQ level 2 qualification in care. And the manager knows what other training staff need, for example training in dementia, and has a training programme in place to address this. The manager has many years experience of managing a care home as a deputy manager. There are good quality assurance systems in place to help make sure care standards are maintained in the home. Service users said: its great I know everybody in here its always clean its top of the pops its a lovely building and the meals are beautiful . Relatives said: staff are brilliant Im over the moon XXXX is in here and they get good meals. What has improved since the last inspection? Care Homes for Older People Page 7 of 23 There were no requirements or recommendations made at the last inspection. 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 on page 4. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by telephoning our order line – 0870 240 7535. Care Homes for Older People Page 8 of 23 Details of our findings Contents Choice of home (standards 1-6) Health and personal care (standards 7-11) Daily life and social activities (standards 12-15) Complaints and protection (standards 16-18) Environment (standards 19-26) Staffing (standards 27-30) Management and administration (standards 31-38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 23 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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 the 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 admissions process ensures that people are adequately assessed prior to care being offered. This means that service users are offered the right type of care at the home. Evidence: For prospective service users, funded by the local authority or primary care trust, the manager obtains a copy of the needs assessment and care plan from the care manager so that she can decide whether Parklands care home is able to meet their needs. A nurse or senior member of staff also completes the homes own pre-assessment with the prospective service user. The manager always makes sure that this member of staff is on duty when the prospective service user is admitted to the home. In this way the manager tries to make the move into the care home a positive experience for people. Service users said in surveys I came to look at the home before I moved in. Care Homes for Older People Page 10 of 23 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is now good information in the care plans about the health and social care needs of the service users. Staff care practices preserve the dignity of the people who live here. Medication administration procedures protect the service users. Evidence: Some of the care plans we looked at for people with dementia had only basic information about the persons care needs and were not person centred. For example: in one care plan it said requires full assistance with all aspects of personal hygiene, but no further information about how this care is to be delivered by staff in a way that this person prefers. In another persons care plan it was not clear whether they needed one or two staff to assist with their mobility. Although when we spoke to staff about this they knew that this person required the assistance of two staff. We spoke to staff who said that falls risks assessments are only completed for those service users who have fallen. These need to be completed for everyone in order to identify who may be at risk and therefore what preventative measures need to be put in place. The manager told us that she is beginning to introduce nutritional assessments for everyone. Care Homes for Older People Page 11 of 23 Daily records did not provide information about the type of care that was being delivered. For example: entries such as wandersome periods, all aspects of care maintained do not provide enough information which then can be used to evaluate the care plans. At the request of the proprietor we met with the manager and proprietor sometime after this inspection to look at care plans again. It was clear that the manager has worked hard to improve these. They now contain step by step information about the support each individual needs to meet their health and personal care needs, including falls risk assessments. No-one in this home has a pressure sore and service user’s weights are regularly monitored. One person was admitted to the home with needs in relation to their nutrition. The home contacted the GP for advice about this and records showed that they had gained over two stone in weight since 2007, which is good evidence of how the health care needs of the service users are addressed. Service users have access to all NHS facilities, including specialist health care professionals, such as Peg nurses. The manager, who oversees the unit for younger adults who have a physical disability, said that she has an excellent relationship with one GP who has provided training sessions for staff on the needs of people with Huntingtons disease. Medication is stored in a locked, secure room. Senior staff order the medication from the prescriptions to ensure that service users are provided with the right medication. There were no gaps on the Medicine Administration Records, (MAR), which we looked at. There is a small stock of controlled drugs. These are stored securely, and accurate records maintained of when they have been administered. During our inspection time was spent with service users who have dementia. Staff were respectful in their approach towards the service users and ensured that their privacy was respected. Personal and intimate care tasks were carried out in the privacy of service users own bedrooms. Staff referred to service users by their chosen form of address and it was evident that a good rapport existed between the staff and service users. However, all of the bedrooms and visitors lounge were kept locked, which is not good practice in dementia Care Homes for Older People Page 12 of 23 care. This meant that service users were not able to spend time in the privacy of their bedroom should they so choose. When we met with the proprietor and manager after the inspection we found that the practise of locking doors had stopped. Relatives said care is brilliant Service users said very happy with the care Care Homes for Older People Page 13 of 23 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users enjoy a variety of activities, and are able to maintain family and other contacts if they want to. This ensures service users have opportunities to lead a fulfilling lifestyle and do not become socially isolated. Service users are able to exercise control and choice over their lives, as far as is possible, which enables them to remain independent. Service users receive a varied menu, which promotes their general health and wellbeing. Evidence: The range of activities available to service users is displayed throughout the home. There is an activities co-ordinator and when we visited she was involving the service users in a film session. We spoke to the activities co-ordinator who told us that she is beginning to build up life history information for people with dementia, by talking to relatives and friends. She is going to use this information to develop the activities programme further, which is good practice in dementia care. Some service users enjoy 1:1 time with the activities co-ordinator going out shopping. The home also has WII fit which is used to encourage the service users to take part in indoor exercises. Opportunities are also provided for people to enjoy baking sessions. Care Homes for Older People Page 14 of 23 A newsletter is published called Parklands Gossip which keeps the service users informed of what’s been happening in the home. There is also a separate activities room where service users are involved in craft sessions. Throughout our visit family and friends were seen to freely come and go. We spent time with people with dementia whilst lunch was served. During this process service users were offered a choice of what they would like to eat. And staff offered support in a sensitive, discrete way where service users needed this. However, the tables were bare without table cloths and napkins. There is a menu, but this is in small print, which may be difficult for some people to read. It was also not available in picture format which may further assist some people with dementia to make choices for themselves. Service users said in surveys that they can make decisions and do what they want each day. Service users said: the foods nice and “the food is champion. Relatives said: they get good meals and at Christmas they have a lovely spread. Care Homes for Older People Page 15 of 23 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using the 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 home has a good complaints procedure so people know that their views will be listened to and acted upon. Staff training and policies and procedures on prevention of abuse protect the service users. Evidence: Service users told us that they knew who to speak to if they were not happy. The manager told us that there have been no complaints in the last twelve months. Staff told us that they have had training regarding prevention of abuse and the manager is in the process of arranging additional training for staff in this area. However, the manager did not have a copy of the local authority safeguarding policy and procedure and therefore information about what to do should staff witness or suspect abuse was not available. When we met with the proprietor and manager sometime after this inspection, the manager confirmed that she has obtained a copy of the local authority safeguarding policy and procedure. Care Homes for Older People Page 16 of 23 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, 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. This is what people staying in this care home experience: Judgement: People using the 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 home is clean and well maintained. However, although the home offers a specialist service to people who have dementia, the environment has not been fully adapted to meet the needs of this client group. Evidence: There were no unpleasant odours when we visited and service users commented in surveys that the home was always clean and fresh. Some areas of the home need attention, for example, paintwork on doors is damaged, the bathroom floor in the dementia unit is damaged and the corridor carpets are stained. The manager said that she does a weekly maintenance check of the building, is well aware of these issues, and has plans in place to address them. When we did this inspection there was very little to help people with dementia find their way around. For example: it is good practice in dementia care to have items familiar to the individual on their door to help them find their own bedroom, grab rails and toilet seats should be bright contrasting colours to help people see them. When we met with the proprietor and manager sometime after this inspection it was evident that the manager was looking at ways of how to improve the environment for people with dementia, for example: photographs of service users have been placed on their bedroom doors to help them find their own room. Developments in this area should continue. Twenty seven staff have completed training in infection control. Care Homes for Older People Page 17 of 23 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels are sufficient, which ensures staff provide person centred care. Staff training is satisfactory and includes specialist training in order to meet the diverse needs of the service users. Staff recruitment procedures fully protect the service users. Evidence: Each unit is staffed and operates independently of one another. The manager is responsible for the unit where the younger people with a disability live. Three care staff were on duty for those 24 service users. There are only 7 people currently living on the residential unit and 1 member of care staff was on duty here. The deputy manager, who is a nurse, is responsible for the management of the unit where people with dementia live. There were 2 care staff on duty with her when we visited. In addition to care staff there were two kitchen staff, 3 domestics, a laundress an activities co-ordinator and administrator on duty. There has been a low turnover of staff, which is good for continuity of care. Twenty three out of the twenty six care staff have completed the NVQ level 2 qualification in Care Homes for Older People Page 18 of 23 care or above. Some staff have put their names forward to complete the NVQ level 4 qualification in care. A new training programme is being introduced. Currently staff are completing training in infection control and health and safety. Some are undertaking training in equality and diversity, palliative care and care of the dying. We spoke to staff about training in the needs of people with dementia. They said that they had not received any yet but the manager is arranging this for them. Training records showed that other staff have completed this training. Relatives and service users spoke positively about the staff and there was clearly a good rapport between the service users and staff. Service users said staff are brilliant, they are very nice indeed, they are very gentle and excellent staff. All new staff complete induction training. Staff files showed that the companys recruitment procedures are followed. This includes obtaining two written references and an Enhanced Criminal Records Bureau check to ensure that the prospective staff member is suitable. Care Homes for Older People Page 19 of 23 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good management systems ensure the health, safety and welfare of service users. Evidence: The manager has worked for the company for a number of years as the deputy manager and at the time of the inspection had been managing this home for two months. She is a Registered General Nurse and continues to up-date her knowledge and skills by attending other training, alongside her staff, such as health and safety and phlebotomy. The manager is clearly committed to improving the service for service users. She achieves this by providing good training for staff which is supported by regular supervision. We looked at how the home manages the service users personal allowance. Satisfactory records of these are maintained and receipts are obtained for any money deposited or withdrawn. Care Homes for Older People Page 20 of 23 The home carries out internal maintenance checks and has contractors to service equipment. The quality assurance system involves a detailed audit of care standards including medication and environmental issues. A traffic light system is used to highlight any areas that need to improve. Records are maintained of all accidents and incidents so that the manager can monitor the occurrence of these. Care Homes for Older People Page 21 of 23 Are there any outstanding requirements from the last inspection? Yes No 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 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 1 15 Tables should be nicely presented at mealtimes and consideration should be given to providing menus in different formats to help some people with dementia make choices about what to eat. The environment should continue to develop to meet the needs of people with dementia. This is to ensure the welfare and independence of the service users is fully promoted. 2 19 Care Homes for Older People Page 22 of 23 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. If you would like a summary in a different format or language please contact our helpline or go to our website. ©This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI. Care Homes for Older People Page 23 of 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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