Care Home: Parkside

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What the care home does well the home has a welcoming atmosphere and the standard of cleanliness is extremely high.The home provides good quality care to the residents who are living there. Care plans are person centred and we saw good interactions between the staff and residents. Medication administration and record keeping is of a good standard with the safety of the residents being a priority. The service has good relationships with the GP, community and McMillan nurses. Staff retention is good and staffing levels are more than adequate. Residents were very complimentary of the staff and said how kind and thoughtful they were and that nothing was too much trouble. What has improved since the last inspection? The extension at the back of the home has been completed and provides another 5 ensuite bedrooms and further refurbishment and redecoration in the home has taken place. The service has engaged a training company to provide in house training for staff. Senior care staff have attended training in the writing of care plans and all of the permanent care staff are trained to NVQ 2/3. There has been improvement in the recording on the Medication Administration Records; all changes in a resident`s medication are being signed and dated by staff. What the care home could do better: We had a discussion with the manger regarding the residents comments in relation to activities within the home and in the wider community. She acknowledged that this is an area were more work was required and will be having discussions with the residents. The food in the home is wholesome, balanced diet with most of the food being homemade. However the manager must ensure that the menus reflect that residents have a choice of meals at lunchtime. Key inspection report Care homes for older people Name: Address: Parkside 65 Main Road Gidea Park Romford Essex RM2 5EH     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 review of the service. We call this full review a ‘key’ inspection. Lead inspector: Julie Legg     Date: 0 3 0 9 2 0 0 9 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 Older People Page 2 of 25 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 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 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 Older People Page 3 of 25 Information about the care home Name of care home: Address: Parkside 65 Main Road Gidea Park Romford Essex RM2 5EH 01708743110 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: parksidehome@btinternet.com Romford Baptist Church Housing Association Limited care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: As agreed on 08/06/2006, one named Service user (Female), with Dementia, can be accommodated within the home. Date of last inspection Brief description of the care home Parkside is a registered care home for 32 people aged 65 and over. Parkside is operated by the Romford Baptist Church Housing Association Ltd., a registered charity. The home is run on a Christian basis, and most of the staff are Christians. However, the registered providers accept people from all beliefs and backgrounds. The home is situated in a residential area of Romford. It is on several bus routes and approximately a fifteen minute walk from a main line station. The home is a large two storey detached house with extensions, the house is set back from the main road and surrounded by well-maintained gardens. The accommodation is over two floors two of the bedrooms are double rooms and the remaining rooms are single with either enCare Homes for Older People Page 4 of 25 Over 65 1 32 0 0 Brief description of the care home suites or wash hand basin facilities. There are ample toilet and bathing facilities on both floors, which are served by a passenger lift. There are three communal lounges including the conservatory and a spacious dining room. There is also a pleasant and well-maintained garden at the back of the home. The Statement of Purpose and the Service User Guide are available to every prospective resident and every resident has a copy of the Service User Guide. A copy of the Statement of Purpose and the most recent inspection report is available from the office. The current fees for the home are between £496.26-£553.50 a week, this information was provided by Gillian Littleboy (registered manager). Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We carried out an unannounced key inspection on Thursday 3rd September 2009 over a period of 7 hours. the inspection involved a tour of the premises, discussions with the manager, staff, residents and visitors. we also looked at records, other documentation, the completed Annual Quality Assurance Assessment (AQAA), regulation 37 notifications. We also case tracked 4 residents. Care Homes for Older People Page 6 of 25 What the care home does well: What has improved since 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 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 Older People Page 7 of 25 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 8 of 25 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 this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may use the service are given the information they need to help them decide whether the home is right for them. Evidence: We sawa copy of the Statement fo Purpose, Service User Guide and the last inspection report in the reception area of the home. From viewing files we were satisfied that residents and/or their relatives are given a copy of a contract or terms and conditions of residency at Parkside. There was also evidence that all residents have had a comprehensive assessment undertaken to ensure that the home can meet their needs prior to moving into the home. the full assessment is completed on admission to the home and this would include areas such as preferred place of care, end of life wishes and various risk assessments. Admissions to the home takes place once the service is confident that staff have the Care Homes for Older People Page 9 of 25 Evidence: skills, ability and qualifications to meet the assessed needs of the prospective resident. Prospective residents are given the oppurtunity to spend time in the home and a member of staff will spend time showing them round the home and introducing them to other residents and members of staff. Care Homes for Older People Page 10 of 25 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 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 health and personal care that peo;ple receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: From case tracking, observations and discussions with residents, staff and visitors we were satisified that residents receive personal and gelath acre support using a person centred appraoch. This is provided based upon the rights of their dignity autonomy and respect and residents are encouraged to be as independant as possible. Personal support is flexible, consistent and is able to meet the changing needs of the residents. Staff were able to demonstrate a good knowledge of the rersidents individual preferences and ensured that these were met. We observed staff members being alert to residents changing needs and their general well being. Residents have access to health care and remedial services. Staff make sure that those who are fit and well enough are encouraged to be independant, have regular appointments and visit local health care services. The health care needs of residents unable to leave the home are managed by visits from local health care services. Care Homes for Older People Page 11 of 25 Evidence: Weights are being monitored on a regular basis, some more frequently where there are concerns. Staff were very aware of the need to ensure that fluids are freely available and also the need to ensure that residents are eating a balanced diet. Where concerns are identified referrals are made to the GP/Dietician. Residents have the aids and equiupment they need and these are well maintained to support them and staff in daily living. We looked at the medication recording, storage, administration and disposal and found that this was being carried out in accordance with the homes policies and procedures. regular management checks are recorded to monitor compliance. Staff members involved in the administration of medication have received the necessary training. Residents were very complimentary of the support and care they receive; comments included: The girls are wonderful, nothing is too much trouble, they are all very respectful and always knock on the door before entering. A relative stated, I have nothing but good things to say about the staff, they are kindness themselves, they never hurry her and the standard of care is very good. The service is now caring for residents who are terminally ill or dying and their wishes or where necessary those of the family are sensitively discussed during the development of a person centred plan of care and recorded. Staff have received training and work closely with external professionals to ensure that residents receive a high standard of care. Care Homes for Older People Page 12 of 25 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 this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make some choices regarding their life style however a more varied activities programme needs to be implemented to meet the indivudal choices and aspirations of the people who use the service. Evidence: Residents were asked their views and care plans and other records were examined. Both the Annual Quality Assurance Assessment (AQAA) and records kept at the home still show a limited activities programme. The AQAA did identify that more outings using the mini bus have taken place and there is now a selection of videos/DVDs in the lounge. Some of the residents are involved in the upkeep of the garden and there has been visits from the PAT dog. Some of the residents are able to access the community independantly and others go out with their families. The religous needs o the residents are also respected and met. Some of the residents commented on the limited variety of activities, I would like to go out more often and I would like to go to theatre. On the day of the inspection ther were very few activities taking place; a volunteer from the local Baptist church was visiting some a few of the residents and was reading to them, some of the residents were sitting reading the newspaper/books. The manager is aware that this is an area of the service provided that requires more attention and will be in discussion with the residents as to what their preferences are. Care Homes for Older People Page 13 of 25 Evidence: Visiting times are flexible and visitors confirmed that theycould visit at any time they wished. Residents have the choice as to whther they see their relatives. the signing-in book showed that there is a steady stream of visitors to the home. Residents care plans indicate their preferred name and their wishes regarding their end of life. Residents meetings are taking place and they are involved with some of the decision making within the home such as; menu planning, updates on staffing. Some of the residents take responsibilty for thei own medication and finances as well as their bedroom door key. The dining room was congenial with tables being appropriately laid with cloths, flowers, cutlery, cruet glasses and napkins. We observed lunch being served and the meals appeared to be well balanced and catered for the varying dietary needs of the residents. For those that required support during mealtimes, staff were on hand to give the necessary assistance in a discreet and sensitive manner. Mealtimes appeared relaxed with residents being given time to finish their meal in their own time. We looked at the menus for the week and there was no evidence that the residents had a second choice at lunch time. Residents comments were varied; Food could be more varied, there is not always a choice, its a bit repetitive and food is fine.We discussed this with the manager who will talk to the residents during their meeting to look at alternative choices to the main meal. Care Homes for Older People Page 14 of 25 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 this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the servcie can feel confident that they complaints will be listened to and acted upon. that they are protected from abuse and that their rights are protected. Evidence: The home has a satisfactory complaints procedure in place, which is displayed in the main hallway. The complaints book was examined and there had been no complaints recorded since the last inspection. We had a discussion with the manager and advised that all complaints however small should be recorded. Previosu complaints have been dealt with appropriately. We were told by some of the residents that they were satisified with the service and would tell either Gillian (the manager) or a member of their family if they had any complaint. For those residents who do not have any family there are regular volunteer visitors from the local Baptist church, who would advocate on their behalf. Some of the residents administer their own finances, whilst ohers receive assistance from relatives or solicitors. the home holds small amounts of money for hairdressing, chiropody, newspapers and other small sundries. there is a written procedure and policy for dealing with safeguarding issues. Staff confirmed that they had undertaken training in recognising abuse and dealing with safeguarding issues. This topic is also covered during staff induction and during staff Care Homes for Older People Page 15 of 25 Evidence: meetings. This was also confirmed in the Annual Quality assuarnce Assessment (AQAA) which had previously been submitted by the service. The Care Quality Commission has not recieved any complaints nor has there been any safeguarding allegations about the service since the previous inspection. Care Homes for Older People Page 16 of 25 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 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 home provides the residents with a safe, well manintained and comfortable environment Evidence: We undertook a tour of the building and found the home to be clean and free from any offensive odours. There are a high number of domestic staff and this was evidenced in the high standard of cleanliness throughout the home. Residents told us that the home is always kept clean and well maintained and staff were seen to be practising appropriate infection control methods. The Annual Quality Assurance Assesment (AQAA) identified that regular maintenance of equipment has taken place; electrical circuits, lifts, fire alarms, heating system, gas appliances and emergency lighting. The home has an ongoing redecoration and refurbishment programme. All of the living and dining areas were appropriately decorated and furnished; there are three different sitting areas including a conservatory and the dining room is furnished with small dining tables that encourage homely living. Most of the bedrooms are single and either have en-suite or wash hand basin facilities and are personalised by the residents. There are sufficient toilets and bathrooms on both floors; there are four bathrooms Care Homes for Older People Page 17 of 25 Evidence: which suit all bathing requirements. We visited the kitchen and laundry area and these were fouind to be clean and well amintained.The home also provides other specialist equipment and aids to meet the needs of the residents. The garden areas are maintained but the home has recently lost its gardener and the work is now being carried out by volunteers from the local Baptist church. Since the last inspection (September 2007) the annex at the back of the house (Rose wing) has been completed and offers 5 single en-suite bedrooms. This wing of the home is for residents with higher care needs (not nursing). A number of the bedrooms have been redecorated, the kitchen store has been redecorated, reshelved and new flooring laid and the summer house roof has been restored. Residients were complimentary of the environment, comments included: It is always lovely and clean and it isnt quite the same as your own home but its a good second best. Care Homes for Older People Page 18 of 25 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 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. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service. Evidence: The service has a well developed recruitment procedure and the recruitment of good quality carers is seen as integral to the delivery of a good service. All of the appropriate checks are undertaken prior to a position being offered. Staff then undertake a robust induction proramme and a probationary period. Staffing rotas were examined and discussed with the manager. Rotas showed that the service has good staffing ratios with particular attention given to busy times of the day, which enable staff to support the needs of the residents at peak time of activity. the staffing strucutre is based around delivering a good service and is not led by staff requirements. the home now has its own bank staff, which ensures that the residents receive consistent care from staff who know them. The manager prioritises training and facilitates staff memebers to undertake external training beyond the basic requirements. The home has engaged a training company to provide in-house training on a number of different topics. More than 75 of staff are NVQ 2 trained and two of the staff are undertaking the NVQ 3. Other training including: record keeping, report writing, fire safety, first aid, moving & handling, Care Homes for Older People Page 19 of 25 Evidence: medicines use in care homes and infection control have also taken place. There was evidence that staff meetings are regualrly taking place and are used for consultation and training. Individual supervision sessions and yearly appraisals take place regularly and notes and actions points are recorded and progress is regularly reveiwed. Staff told us that they find supervision and training useful for thei own personal development and for the benefit of the residents. Residents that we spoke to were very complimenary of the staff comments included: they are all great, nothing is too much trouble and they all do what they can. Care Homes for Older People Page 20 of 25 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 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 home is managed by a qualified and experienced manager and ensures quality care to the people using the service. Evidence: The registered manager has the necessary qualifications and experience and is competent to run the home and meet its stated aims and objectives. She is committed to providing and improving the quality at the home and to achieve this she works closely with health professionals and the Commission. She has sound financial planning and budgetary control and is aware of her budgetary limitations. In discussion with the manager it is clear that the home has regular and effective support from the Parkside Housing Committee and there are clear lines of accountability. The manager was able to demonstrate an awareness of current legislation and developments and plan the service accordingly. The returned Annual Quality Care Homes for Older People Page 21 of 25 Evidence: Assurance Assessment (AQAA) was clear and contained relevant information supported by a wide range of evidence seen during the inspection. The service has sound policies and procedures which are regularly reviewed and the manager ensures that staff follow them. The home works to a clear health & safety policy. The manager and her staff have a good understanding of risk assessment processes which is underpinned by promoting independence, choice and autonomy. Maintenance records are up to date as evidenced through the AQAA and in discussion with the manager. we are also satisfied that the financial interests of residents are safeguarded and that their best interests are protected by the administration and record keeping. Monthly visits required under Regulation 26 of the Care Home Regulations 2001 are undertaken and the service continues to inform us of any as required under Regulation 37 of the Care Home Regulations 2001. Currently there have not been any referrals to the local authority under the deprivation of liberty safeguards. Care Homes for Older People Page 22 of 25 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 Older People Page 23 of 25 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 12 16 For the registered person to 29/12/2009 consult with the residents regarding their social interests and make arrangemnts to enable them to engage in community activities To ensure that residents have a varied and fulfilling life 2 15 16 the registered person must consult with the residents regarding the weekly food menus To enusre that the residents have food which is varied and of their choice 29/11/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - 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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