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Carlisle Dementia Centre - Parkfield Good

Reports


Inspection carried out on 8 August 2018

During a routine inspection

Carlisle Dementia Centre is a care home providing personal care and nursing care for up to 42 people, some of whom may be living with dementia or physical disabilities. There were 38 people living at the home at the time of our inspection.

Accommodation is provided over two floors. The bedrooms are single occupancy and have en-suite toilet and wash basin facilities. There are shared bath and shower rooms, as well as lounge and dining areas throughout the home. There is a sheltered, accessible garden and car parking at the home.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service remained Good. However, there are areas that would benefit from some improvements. We have made some recommendations to the registered provider.

There was a registered manager in post. A registered manager is a person who has registered with the (CQC) to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Medicines were not consistently stored safely or recorded accurately and appropriately. We have made a recommendation about this.

The hot water supply in some areas of the home was not always reliable. The water temperature monitoring procedures were not clear or fully understood by staff. We have made a recommendation about this.

The schedules in place for cleaning had not always been followed. We found some areas of the home required better cleaning. There was a refurbishment plan in place at the home to help make improvements to the environment and the facilities.

The provider had systems in place to help monitor and assess the quality and safety of the service. We found that actions were taken to make improvements to the service. However, the monitoring systems could have been more robustly applied across the service.

Safeguarding concerns or incidents had been reported by the registered manager to the appropriate authorities to help keep people safe.

During the inspection we found that there were sufficient numbers of suitable staff to meet people's needs that plans were in place should extra staff be needed.

Staff were provided with training and support. We saw that staff were confident and competent when supporting the people who used this service.

People were provided with a good variety of food and drink. We saw that mealtimes were a pleasant and sociable event. Staff provided support with eating and drinking in a sensitive and discreet manner. Records about eating and drinking did not always contain enough information about people at risk of poor nutrition.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

Staff were caring, capable and engaged with people throughout the day. They worked very well as a team including the domestic and administrative staff.

People who lived at the home were smartly groomed and appeared relaxed and content. Some people became distressed and anxious in the late afternoon but staff supported them expertly and with kindness.

People were provided with opportunities to have their say on how the service was operated. However, there had been few responses to surveys and meetings.

Further information is in the detailed findings below.

Inspection carried out on 27 September 2016

During a routine inspection

This unannounced inspection took place on 27 and 28 September 2016. We last inspected the service in November 2014 under the regulations that were in force at the time.

Carlisle Dementia Centre- Parkfield (CDC) provides nursing and residential care for up to 44 people, some of whom may have dementia or a physical disability. The home is a three storey property and accommodation is provided on the ground and first floors. The bedrooms are single occupancy and have en-suite toilet and washbasin facilities. There are communal bath and shower rooms as well as lounge areas and dining rooms on all floors. There is a sheltered garden area and car parking at the home.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Care plans were subject to regular review to ensure they met people’s changing needs. They were easy to read, based on assessment and reflected the needs of people. Risk assessments were carried out, and plans were put in place to reduce risks to people’ safety and welfare. The way the service gathered information on people's life history was being improved with the support of the local authority quality officer.

Where people were not able to make important decisions about their lives the principles of the Mental Capacity Act 2005 were followed to protect their rights. Staff were aware of how to identify and report abuse. There were also policies in place that outlined what to do if staff had concerns about the practice of a colleague.

There were sufficient staff to meet people’s needs. They were trained to an appropriate standard and received regular supervision and appraisal. As part of their recruitment process the service carried out background checks on new staff.

The service managed medicines appropriately. They were correctly stored, monitored and administered in accordance with the prescription. People were supported to maintain their health and to access health services if needed. People who required support with eating and drinking received it and had their nutrition and hydration support needs regularly assessed.

Staff had developed good relationships with people and communicated in a warm and friendly manner. They demonstrated good communication skills in relation to supporting people who lived with dementia. They were aware of how to treat people with dignity and respect. Policies were in place that outlined acceptable standards in this area.

There was a complaints procedure in place that outlined how to make a complaint and how long it would take to deal with. People were aware of how to raise a complaint and who to speak to about any concerns they had. The registered manager understood the importance of acknowledging and improving areas of poor practice identified in complaints.

The home was well led by a registered manager who had a vision for the future of the service. A quality assurance system was in place that was utilised to improve the service.

We found some areas of the home to have an unpleasant odour, we made a recommendation about this.

Inspection carried out on 26 September 2014

During a routine inspection

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

� Is the service safe?

� Is the service effective?

� Is the service caring?

� Is the service responsive?

� Is the service well led?

This is a summary of what we found:

Is the service safe?

People were cared for in a clean and hygienic environment. We saw that further investment was required to refurbish parts of the home. The provider was able to show us a schedule of works that confirmed this would be done. On occasion there were not enough staff to meet people's needs in a timely manner. We found the home to be non compliant in this area and a compliance action was made

Is the service effective?

People were cared for effectively because the staff worked in conjunction with other providers to ensure people's needs were met. The service had detailed care plans that ensured people's physical health needs were met.

Is the service caring?

People were cared for by warm and friendly staff who were knowledgeable about the people they cared for. Care plans were based on assessments of people's needs but we judged that they required more person centred information.

Is the service responsive?

The home had a robust complaints policy and staff were able to give good examples of how they had dealt with people's concerns.

Is the service well-led?

Staff had a good understanding of the standards expected by the manager and quality assurance processes were in place. People who used the service and staff had been consulted with about changes and they had been listened to. The provider had ensured there was a corporate quality assurance system in place. The manager provided leadership and was aware of areas that required improvement.

Inspection carried out on 7 January 2014

During a routine inspection

We spoke with people who lived at Carlisle Dementia Centre - Parkfield (CDC). They told us that they were satisfied with the service they received, one person said, "They're very caring staff." Another said, "I don't have any bother at all." Another told us, "I get on with the staff, this place is first class."

We found that people were well looked after by sufficient amounts of staff. The staff worked well with other providers to ensure that people received quality care. Staff had received safeguarding training and were aware of how to identify and report abuse. The home had a quality assurance system in place and acted on people's feedback. However we noted that the home was in need of significant refurbishment though this was underway at the time of our inspection.

Inspection carried out on 15 January 2013

During a routine inspection

We found that people who used this service had their care and support needs assessed. Their care and support needs were planned and usually provided in line with their individual care plan and preferences.

People told us that they were �happy at the home� and that the staff were �kind, helpful and friendly.�

Nutritional assessments and records had been completed and were up to date. Where necessary the doctor or speech and language therapist had been contacted for advice and support. Some of the people we spoke with told us that the food was 'very nice and there are always various things to choose' and 'we can choose what we want to eat, the meals are good and I always have enough to eat.'

We checked all areas of the home including the bathroom and shower areas as there had been concerns about the cleanliness and safety at our last inspection. We found that generally the home was warm, clean and tidy, although we did note that there were some slight unpleasant odours in some areas of the home.

We found that staff were recruited appropriately and relevant pre-employment checks had been completed. This helped to ensure that people were supported by staff that were suitable to work with vulnerable adults.

We found that people living at the home were able to comment on the quality of the service they received. Regular resident meetings were held, surveys were always available for residents and visitors to the home and the manager always took comments seriously.

Inspection carried out on 21 February 2012

During a routine inspection

One of the people we spoke to told us that they had experience of living in other care homes and that �this is the best one.�

Another person told us that they had been admitted to the home straight from hospital. They had been concerned and worried about the move. They told us that �staff were very kind, made me a cup of tea, chatted to me and made me feel comfortable.�

Someone else said; �I can please myself whether I shave or shower daily. I don�t feel pressured to act or behave in any certain way.�

Two people told us that the food was �very good� but another was very upset by the standard and choice of food available. They told us that they �often missed meals� because of this.

Residents we spoke to told us that �the staff are very kind�, �great bunch of girls� and that the manager was �approachable� and �listened to what I have to say.�

A visitor to the home told us that the staff were �generally excellent�.

Reports under our old system of regulation (including those from before CQC was created)