Care Home: Parkville Care Home

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What the care home does well Parkville Care Home provides a comfortable and homely place for people to live. People interviewed were happy with the care and the home. Staff interviewed were committed to caring for the people who use the service. They commented on the positive changes which had been made by the new deputy manager. What has improved since the last inspection? Records showed that forty three out of fifty one carers had achieved NVQ level 2 or above. This is well above the 50% needed and is very good. What the care home could do better: A significant number of areas are needed to be improved upon at Parkville Care Home. Care plans and associated risk assessments need to be reviewed and updated regularly, ensuring they are reflective of the person`s needs. Activities need to be developed further, another activities co-ordinator would soon commence employment to assist with this. All staff must be provided with the training that is appropriate to the work they are to perform, to equip them to meet the people`s needs. To ensure people living at the home are cared for by suitably skilled and trained staff. The quality assurance systems need to be reviewed and must demonstrate that the service is operating in the best interests of people living there. Key inspection report Care homes for older people Name: Address: Parkville Care Home Walpole Street Parkville Care Home Middlesbrough Cleveland TS1 4HA     The quality rating for this care home is:   one star adequate 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: Valerie Daly     Date: 2 4 0 3 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 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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: Parkville Care Home Walpole Street Parkville Care Home Middlesbrough Cleveland TS1 4HA 01642223334 01642223336 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Southern Cross OPCO Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 94 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 94 The registered person may provide the following category of service only: Care Home only Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 41 Dementia Code DE, maximum number of places 53 Date of last inspection Brief description of the care home Parkville is registered to provide personal care to forty-one older people and fifty-three older people with dementia. Parkville comprises of two purpose-built two-storey buildings. Each building is divided into two separate units; the ground floor of each Care Homes for Older People Page 4 of 25 Over 65 0 41 53 0 Brief description of the care home building providing residential care for older people, and the two first floor units accommodation for older people with dementia. The home is registered for a total of 94 persons. The home occupies a large site in the Newport area of Middlesbrough. All bedrooms have an en-suite facility which have a hand wash basin and toilet, 24 hour call system, TV and telephone points. Communal accommodation in each of the four units comprises two lounges; dining room; assisted bathrooms and toilets. In addition there is a large conservatory leading from one of the ground floor lounges. Externally there are patio areas and a large enclosed garden. 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: one star adequate 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: The quality rating for this service is one star. This means people who use this service experience adequate quality outcomes. This Key Inspection was carried out because concerns were being raised by other professionals and the home had been without a permanent manager for since February 2009. The inspection was to check that the home meets the standards that the Care Quality Commission say are the most important for the people who use the service, and that it does what the Care Standards regulations say it must. The inspection was conducted by two regulatory inspectors in one inspection day. The inspection was conducted with the deputy manager and the administrator. Care Homes for Older People Page 6 of 25 During the inspection a number of records were looked at, including records of people who use the service, along with staff recruitment, training records, medication and maintenance. There was also discussion with the deputy manager, care staff and people who use the service. We have reviewed our practice when making requirements to improve national consistency. Some regulations from previous reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not being put at risk or harm. In future if a requirement is repeated it is likely that enforcement action will be taken. Care Homes for Older People Page 7 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 8 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 9 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 have their needs assessed prior to admission, ensuring their needs can be met. Evidence: The care files of four people who use the service were examined, two of which were for the people most recently admitted to the home. In each file there was a copy of the assessment carried out by the home, which was completed prior to people being admitted to the home. There was sufficient information to determine if peoples needs were able to be met by the home. there was also a copy of the local authority/care managers assessment, which detailed care needs. People spoken to confirmed that they or their families had visited prior to moving into Parkville. 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. Care plans and risk assessments are not always updated to reflect peoples current needs. They are not evaluated regularly. Evidence: The files of four people who use the service were examined. All care files contained a number of assessments such as; dependency, nutrition, physical and social, moving and handling. here was also a range of risk assessments and care plans in place. However the assessments in some cases were incomplete and had not been updated monthly. Some of the care plans were well written and contained good information, which was personal to the individual. However one person had a care plan for falls and also one for mobility. The information in them was the same and on reading further, neither plans reflected the persons current needs. Another person has a care plan for eating and drinking, but the plan did not state what the person could do for herself or help needed. The same persons assessment stated they suffered with double incontinence, however there was not a care plan in place. Care Homes for Older People Page 11 of 25 Evidence: A person had a care plan for a pressure sore. A district nurse visited regularly to check and treat the area. A two hour turning programme was in place, but whilst this plan had been in place for some months it had not been evaluated. Daily reports were very repetitive, such as good diet and fluid intake, settled evening, fine. There was no further information about how people spend their days in the weekly reports. Some of the care plans were evaluated monthly but there were gaps of time in others. There was evidence to show that peoples health needs were being met. People had their own GPs and District Nurses visited the home regularly. Visitors were seen to be coming and going, talking with staff and also with their family members. A person living in the home said Im safe here. Another person said I can get up and go to bed when I like. Policies and procedures were in place for the ordering, receipt, storage, disposal and administration of medication. Staffs who administer medication had undertaken training in the safe handling of medication and were competent. Medication and the administration records were looked at in all the units. Staff interviewed were fully aware of the procedures and each unit is responsible for the ordering and disposal of medication. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good contact is maintained between the people who live in the home, relatives and friends. Activities are being developed. A varied diet is provided. Evidence: At the time of the inspection the home employed one person working full time as activity co-ordinator between the units. The deputy manager said that another person had been interviewed and would be commencing at the home as an activity coordinator when satisfactory checks for her had been received. This would ensure that activities would be consistent on both units. Activities such as arts and crafts, music, relaxation and pampering, reminiscence, games and quizzes take place on a daily basis. The deputy manager had also arranged celebrations for Valentines Day and Mothers Day. Some people had enjoyed a trip to Albert Park, where they were given a history tour. A coffee morning had also taken place earlier in the month. A person living in the home said I like the musical bingo. It was noted that late in the afternoon people who were sat in the conservatory had their night clothes on. The deputy said that this should have been because it was their preference and written in their care plans. As there were several people it would be looked into to ensure that was the case. Care Homes for Older People Page 13 of 25 Evidence: Menus showed a variety of food, which is nutritionally balanced, being available for the people who live in the home. People are asked for their meal choices the day before and on the day of the inspection lunch was either pork chops and vegetables or a mild curry and rice followed by rhubarb crumble. There are more choices available if people do not like the main meals, for instance one person said she preferred a sandwich, another person was having some soup. A person said the food is pretty good, I had vegetable curry the other day, it was nice. Another person said the food is very good, I also like the coffee and biscuits. One person enjoys setting the tables in her unit ensuring everything is in place. She said I set the tables after breakfast, dinner and tea. Her comments about the meals were I like small meals, I had pork chops today, it was nice, they know I only like a small plateful, a lot puts me off. 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 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 express their concerns and have access to a complaints procedure. However all complaints should be investigated and have an outcome. It could not be evidenced that staff are up to date with training to ensure people are protected from abuse. Evidence: The home has a complaints policy and procedure in place. There had been four complaints made to the home in the previous twelve months. A complaint made in November by a family relating to missing cigarettes did not have a record of action taken or outcome. Similarly there was no information regarding a complaint made by a Social Worker in January 2010 asking that issues in a persons review be addressed. For a further two complaints made in January 2010 regarding medication and a persons television being too loud, investigation notes were available. A person living in the home said If I had a complaint I would tell the member of staff or report it to the office. For safeguarding of the people who use the service, staff interviewed knew to speak to the person in charge of the home if they suspected any abuse had taken place. However training in safeguarding was not up to date. Care Homes for Older People Page 15 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 physical design and layout of the home enables people who use the service to live in a safe well-maintained and comfortable environment. Evidence: A tour of the home took place. All areas were well maintained, clean and odour free. The communal areas were homely and comfortable. People spoken to during the inspection said whilst there were different areas to relax in during the day they were in their own routines and liked to keep to the same lounges. Bedrooms contained personal items depending on what the person wished to bring with them into the home. Care Homes for Older People Page 16 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the way the home recruits staff, however gaps in employment should be explored. In staffs files examined, induction training and other training could not be evidenced, which does not fully ensure the safety and well being of people living in the home. Evidence: The home has a rota in place, which shows a skill mix of staff being on duty on each shift. Records showed that fourty three out of fifty one carers had achieved NVQ level 2 or above. This is well above the 50 needed and is very good. The home has a policy and procedure in place for the recruitment of staff. Three staff files were examined, being the newest employees. Two showed gaps in employment records and there was no evidence these had been explored. For one staff member both references, for employer and character appeared to have been written by the same person. Induction records were incomplete. From discussion with the deputy manager and looking at records it was agreed that in general training for staff was out of date. Some fire safety training had taken place in the last two months. Five members of staff were interviewed, they all said they enjoyed working at the Care Homes for Older People Page 17 of 25 Evidence: home and looked forward to having a more permanent management team. They felt that there were usually enough staff on duty but had been working a lot of hours to cover staff sickness. It was confirmed that there had been a lack of training but some had been organised for the following weeks. They all said that the new deputy manager was very approachable and was already making positive changes in the home. A person living in the home said They have been short staffed, they have had a lot of sickness. Care Homes for Older People Page 18 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management systems are in place, however they are not being applied. Peoples welfare and well being is not being promoted. Evidence: At the time of the inspection the home had been without a registered manager since February 2009. In the interim, relief managers had been in place. A deputy manager had been appointed from January 2010. Records showed that the last quality assurance monitoring had been carried out in 2008. The deputy manager had held a full staff meeting in January 2010, as the previous was had been early in 2009. A regulation 26 visit had last been done in October 2009 by a manager from another home within the group. During this visit a tour of the home had taken place, records looked at and one relative and six members of staff were interviewed. Care Homes for Older People Page 19 of 25 Evidence: A sample of personal allowance records were examined. There were signatures in place for receiving and withdrawing money. Receipts were available for purchases. However for one person the record showed the account often to be minus. A number of health and safety documents and records were examined at the inspection including the gas safety certificate, hot water temperatures, fire tests, portable appliance tests and various other records. These were all found to be up to date. On looking at staff training records, health and safety training is required. This was confirmed by staff during interviews. Comprehensive health and safety policies and procedures are in place. Care Homes for Older People Page 20 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 21 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 7 15 Assessments of need and 30/06/2010 care plans must be reflective of peoples current needs. They must be evaluated and updated regularly. This will ensure that people have up to date plans, which reflect their current needs. 2 16 22 Complaints made under the complaints procedure must be fully investigated. This will ensure that people are confident that their complaints will be listened to, taken seriously and acted upon. 17/06/2010 3 18 13 Staff must receive training in respect of whistle blowing and protection of vulnerable adults. This will ensure the protection, welfare and well being of people living at Parkville. 17/06/2010 Care Homes for Older People Page 22 of 25 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 4 30 18 All staff must be provided 30/06/2010 with the training that is appropriate to the work they are to perform, and that will equip them to meet peoples needs. To ensure people living at the home are cared for by suitably skilled and trained staff. 5 31 7 A manager for the home must be appointed. This will ensure there is a person who is in full time, day to day charge of the home. 17/06/2010 6 33 24 A review of the quality assurance system must be made to ensure it is effective. To demonstrate that the home is being run in peoples best interests. 30/06/2010 7 38 10 All staff must receive training that is appropriate to the work they are to perform. This will ensure that peoples needs are being met by staff who have the appropriate knowledge, skill and experience. 30/06/2010 Care Homes for Older People Page 23 of 25 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 3 12 29 35 For the activites to be developed further when another activities co-ordinator person is employed. Gaps in peoples employment history should be explored. Peoples personal allowance records should not show minus amounts. 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. 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