Archived: Parikia Residential Care Home

This service was the subject of a whole service safeguarding strategy plan implemented by Devon County Council. This meant that a range of health care professionals visited the home regularly to monitor the risks that had been identified through the safeguarding investigation.

We did not follow up any outstanding compliance actions previously made by CQC during this visit.

We visited the home on this occasion because concerns had been raised with us relating to:

' People living at the home being restrained inappropriately.

' Staff using the 'PIN' numbers of people living at the home to withdraw monies from their bank accounts.

' The home being unclean and chemicals being left in un locked cupboards and

' No one overseeing medications which were going missing.

We spoke with the manager of the home and two members of staff. We did not speak with anyone living at the home on this occasion.

We found that people who use the service were not protected from the risks of financial abuse.

We found that people who use the service were not protected from the risks of infection or from the potential harmful effects of substances which are hazardous to health.

We found that people were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

Following our inspection we provided the safeguarding team with a summary of our findings and the associated risks.

The provider had the following outstanding compliance actions which will be followed up at the next inspection:

Outcome 1: Respecting and involving people who use services

Outcome 2: Consent to care and treatment

Outcome 5: Meeting nutritional needs

Outcome 8: Cleanliness and Infection control

Outcome 9: Management of medicines

Outcome 10: Safety and suitability of premises

Outcome 12: Requirements relating to workers

Outcome 14: Supporting workers

Outcome 16: Assessing and monitoring the quality of service provision

Outcome 21: Records

The provider sent us an action plan on how they were going to achieve compliance with the outstanding compliance actions.

This service became the subject of a whole service safeguarding strategy in May 2012, which was ongoing. The service was being monitored via this process. All the people living here were being reassessed by the funding authorities, and the service was being visited weekly by a social care manager and by the responsible manager for safeguarding. The provider had continued to work with all agencies involved to make the required improvements. The provider had cancelled all contracts with people who were receiving respite or day care so that they could focus on meeting the needs of the seven people living there.

As part of this inspection we reviewed all the information we held about this provider before visiting. We visited unannounced and during the visit looked at records, observed how people were being cared for, looked at records of people who used the services and spoke with one person living at the service. We spoke with the registered manager, the registered providers (owners) and with three members of care staff, including one member of agency staff. We were able to speak with one person living at Parikia because other people were out or could not answer our questions because of their profound communication needs. On this occasion, although the views of people living here were important, we focussed on what actions the providers and registered manager had taken to address the risks to people's safety identified at the previous inspection.

One person told us they were happy, and other people, who could not talk with us, appeared to be relaxed. Staff were respectful and helpful to the people they supported. One person said they liked doing the activities they did and liked their holidays. They told us about one thing they did not like, and which affected their behaviour. A care worker told us that action was being taken in relation to this which involved the possibility of another person being moved from Parikia. However, records showed that there was not a risk assessment or action plan in place which addressed the issues identified, whilst awaiting the outcome of this process.

Other records showed that risk assessments and care plans were being reviewed and updated. Although this was yet to be completed. Care plans did not always include information about and potential learning from recorded incidents of individual's aggressive behaviour.

Care plan documentation did not include evidence of proactive and reactive support strategies and did not always provide sufficient detail about actions which could trigger, prevent or de-escalate aggressive episodes. They did not include primary and secondary goals, evidence of skills development or personal aspirations.

Staff told us that they felt better able to meet people's care and welfare needs because of improved communication about people's needs and increased staffing levels. They said that some staff who were inexperienced were being better supported to develop skills to care for the people living at Parikia. Staff also said that their feedback about the people they supported was being used by the management team to help better meet people's needs. The said the introduction of a new deputy manager had provided a good link between support staff and the management team.

There was no evidence that inappropriate or excessive restraint was being used. Staff had received additional support to ensure this did not occur. Updated training in safeguarding adults had been arranged for all staff, who demonstrated a good understanding of abuse and what actions to take if they suspect or witness abuse. Some staff did not demonstrate a good knowledge in relation to decision making and deprivation of liberty. Some staff have not received training in this, or had last received it in 2009.

During our visit we observed people enjoying themselves and interacting positively with the staff supporting them.

One person told us they liked living in the home and enjoyed going out on plenty of different activities.

We were told by a Care Manager for one of the people living in the home that the home that they had no concerns relating to the care the person received.