Archived: Parade Rest Home

Parade Rest Home is a residential care home that was providing personal care to 11 older people, some of whom were living with dementia.

People’s experience of using this service:

We observed medicines being administered and looked at how they were managed. While staff were kind and patient during the dispensing of medicines, staff did not always follow good practice guidance around the management of medicines. We have made a recommendation about this.

People told us they felt safe at Parade Rest Home. Relatives stated they believed their family members were made safe by the care they received. Staff told us they had appropriate training, knowledge and support to keep people safe. Staff could tell us how they managed risk and behaviours that challenge in a way that respected the person and supported their dignity.

People and their relatives we spoke with felt confident in the management. They told us there was a caring culture within the home and staffing levels were appropriate. One person told us, “When I ring the bell staff always come.”

It was clear staff morale was good and everyone was committed to ensuring people received care and support based on their preferences and life choices. The registered manager told us the low staff turnover allowed positive relationships to be built with people receiving support and strong teamwork to develop. People who lived at Parade Rest Home expressed positive views on how they were treated by staff.

Observations during our inspection showed people were respected and care and support was delivered in a dignified manner with consent being sought before any actions were taken. We saw the use of eye contact, appropriate touch and humour to engage and foster positive relationships.

Care plans had been developed with people and their relatives being involved throughout the process. These were regularly reviewed to reflect people’s current needs. The management of risk was included within the care plan to minimise the likelihood of preventable harm occurring.

Staff files we looked at evidenced the registered manager used the same safe recruitment procedures we found at our last inspection. Staff told us training was ongoing and they were supported to gain vocational qualifications in health and social care.

Staff supported people with their meals sensitively and respected their wishes. Plate guards were used to promote people’s independence and staff were available to provide support should it be required. We observed one person start to eat their meal independently but accepted support to finish when they became tired. Everyone we spoke with told us the food was good and the registered manager ensured people always had access to food, drink, snacks and cake.

There was a complaints procedure which was made available to people and their family. People we spoke with told us they were happy with the support they received.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys to seek their views about the service provided. We noted activities were provided as part of the care people received. People told us they enjoyed the visiting singer and photographs showed us regular activities took place.

The service engaged with outside agencies to ensure people received timely healthcare support. The management team engaged with other agencies to gain updates on legislation, best practice and learn from other providers’ experiences.

More information is in the full report.

Rating at last inspection:

Good (Report published 23 August 2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up: ongoing monitoring; possibly more about how we will follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme or if any issues or concerns are identified.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

At the last inspection on 29 May 2014 the service was meeting the requirements of the regulations that were inspected at that time.

Parade Rest Home is located in a quiet residential area of Blackpool and is close to the town centre. There are private parking facilities at the front of the building. There are six single and four double bedrooms located in the first and second floors. Communal space provided included a lounge and lounge/dining room both located on the ground floor. The service can accommodate a maximum of 14 people of whose primary care needs are those of persons who live with dementia. At the time of our inspection visit there were 12 people who lived at the home.

There was a registered manager in place. 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.

We found the registered manager had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

The environment was maintained, clean and hygienic when we visited. No offensive odours were observed by the inspector. One person visiting the home said, “My friend is very happy here and loves her room. It is clean and comfortable.”

We looked at the recruitment of one recently appointed staff member. We found appropriate checks had been undertaken before they had commenced their employment confirming they were safe to work with vulnerable people.

Staff spoken with and records seen confirmed training had been provided to enable them to support people who lived with dementia. We found staff were knowledgeable about the support needs of people in their care.

We looked at how the service was staffed. We found sufficient staffing levels were in place to provide support people required. We saw the deployment of staff throughout the day was organised.

We found equipment used by staff to support people had been maintained and serviced to ensure they were safe for use.

Care plans were organised and had identified the care and support people required. We found they were informative about care people had received. They had been kept under review and updated when necessary to reflect people’s changing needs.

We found people had access to healthcare professionals and their healthcare needs were met. We saw the service had responded promptly when people had experienced health problems.

Care practices observed confirmed people were supported by caring, kind and patient staff. One person who lived at the home said, “I love living here. The staff are brilliant and I feel safe and well cared for.”

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept with appropriate arrangements for storing in place.

People who were able to talk with us said they were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration.

People told us they were happy with the activities arranged to keep them entertained. These were arranged both individually and in groups.

The service had a complaints procedure which was made available to people on their admission to the home. People we spoke with told us they were comfortable with complaining to staff or management when necessary.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys and care reviews. We found people were satisfied with the service they received.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with dignity and kindness by the staff. Most people who lived at The Parade rest home had limited verbal communication. However they were able to tell us their views of the home and the care they received. People said that they felt safe and were receiving good care which was meeting their needs. They indicated that staff were kind and that they received care and support when they wanted it.

The home had policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Relevant staff had been trained to understand when an application should be made and in how to submit one.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

We saw that service contracts were in place. Maintenance records we looked at showed that regular safety checks were carried out. These measures ensured the home was maintained so people were safe.

The registered manager set the staff rotas. People's individual care needs were taken into account when staffing the home. Additional staff were provided when needed. This helped to ensure that people's needs were always met.

Is the service effective?

People's health and care needs were assessed and reviewed. They were developed with them where possible, or with their relatives, where appropriate. This included the way each person's care was provided, their daily routines and their health needs. We saw that care plans were up to date and reflected people's specific needs.

People confirmed and records showed that people were able to see their visitors in private and that friends and relatives could visit whenever they wished.

The individual needs of people were taken into account with the layout of the home enabling people to move around freely and safely. The premises were suitable to meet the needs of people with physical impairments.

Is the service caring?

People were supported by kind, attentive and informed staff. We saw that staff showed patience and gave encouragement and guidance when supporting people. Good care practices were observed.

People said that they were happy at The Parade. They said staff were helpful and respectful. One person said, 'All the staff are good here.' Another person told us, 'Oh yes they look after us well.' A relative told us of the care his family member received, 'It is so much better than the previous home she was in. She is well looked after here and seems happy.'

Care plans had been regularly reviewed, recording the care and support people were receiving. Care and support had been provided in accordance with people's wishes.

The views of people who lived at The Parade, their relatives, friends and other professionals were sought. They were encouraged to complete satisfaction surveys. Where suggestions were made or shortfalls or concerns were raised these were quickly addressed.

Is the service responsive?

People spoken with said they were happy with their care and had no complaints. We saw that staff modified the assistance they provided for people as their health needs reduced or increased. Assistance from other professionals was sought as needed.

We found a range of meaningful social and leisure activities were organised to stimulate people and maintain skills. People indicated that they enjoyed these and were enthusiastic about them. One person said, 'We are having the band this afternoon. They are good fun.'

Is the service well-led?

The service had a quality assurance system in place. Records showed that any identified problems were addressed promptly and suggestions for improvements acted upon. Staff regularly reflected on whether an individual's care could be improved upon or managed more effectively. As a result of these measures the quality of the service was continuously improving.

Staff had a good understanding of their roles and responsibilities and of the ethos of the home. They felt that they worked together effectively. Meetings were held regularly so everyone could discuss support needs and any changes in care or routines. This helped to ensure that people received a good quality service at all times.

During the inspection we looked at care planning, food preparation and staff training records. We also talked with residents about the home. Comments were positive and included, 'It is a lovely homely home.' Also, 'The staff are wonderful.'

We spoke with people who lived at the home. They told us they could express their views and were involved in making decisions about their care. They told us they felt listened to when discussing their care needs. Staff confirmed to us they also involved people to ensure they received the right care and support.

We spoke with residents about their diet and how their nutritional needs were being met. They told us they were satisfied with the food provided and felt the home cooking was good. One resident said, 'There is always plenty to eat and choices if you don't like the lunch or tea.'

There were a range of audits and systems in place to monitor the quality of the service being provided.

Prior to our visit we contacted Blackpool contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.

This home cared for people with a range of dementia conditions and conversation with some residents was limited due to their dementia. We therefore spent much of the time in the communal areas making observations of how people were being cared for.

We were able to speak with four residents during the day of the inspection about their care and support. People we spoke with told us they could express their views and were involved in discussions about their care. They told us they felt listened to when discussing their care needs. One resident told us, 'The food is great and the staff are like family.'

When asked about routines and activities in the home people we spoke with told us it was relaxed and 'quiet'. A married couple we spoke with told us the home provided entertainers monthly and also said, 'In summer we like to go out and the staff take us.'

Staff we spoke with told us they have worked at the home for a number of years and they all got along well. Comments included, 'We have been here years and I love it.'

We contacted the Blackpool contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.