Archived: Parkdale

Parkdale is a care home that provides accommodation and personal care for up to six people who have a learning disability and may have a physical and/or a sensory disability. There were six people living in the service when we inspected. The service is located in a residential road in Colchester, Essex. Each person has a single room and there is a communal bathroom, shower room, kitchen, dining room and lounge. There is a rear enclosed garden at the back of the bungalow with level access.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At the last inspection, in April 2017, the service was rated Good overall with requires improvement in Effective and Well Led. This was because we found concerns relating to staff not receiving appropriate training and supervision and we could not be assured that the registered manager had oversight of the running of the service. At this inspection, we found the service remained Good in Safe, Caring, Responsive and improvements had been made within the Effective and Well Led domain.

The service has 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service was safe. The provider’s recruitment processes ensured that appropriate checks were carried out before staff commenced employment. There were sufficient numbers of staff on duty to meet the needs of people and keep them safe from potential harm or abuse. People’s health and wellbeing needs were assessed and reviewed to minimise risk to health. The service had a good management and monitoring structure in place for medication.

The service was effective. People were cared for and supported by staff who had received training to meet their needs. The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported to eat and drink enough as to ensure they maintained a balanced diet and referrals to health and social care services was made when required.

The service was caring. Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people’s preferences. Staff always worked hard to promote people’s independence through encouraging and supporting people to make informed decisions.

The service was responsive. People and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis and also when there was a change in care needs. People were supported to follow their interests and participate in social activities. The service responded to complaints received in a timely manner.

The service was Well Led. The service had systems in place to monitor and provide good care and these were reviewed on a regular basis. The registered manager told us that current systems and processes where being updated and improved.

There was a registered manager in post. 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.

During this inspection, we found that the registered provider was in breach of two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

There was a lack of effective oversight and support from the provider. The provider had not consistently supported the service to ensure people were receiving care and support in a safe manner and in line with the current regulatory standards.

The service had a quality assurance system in place which was used to identify shortfalls and to drive improvement. However, some areas were not being effectively monitored such as training and the quality of the care records.

Staff had not been provided with all of the training they needed to meet people's needs safely and effectively. Three members of staff had not received moving and handling training.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. However, the provider’s policies did not support this practice as the policy regarding the Deprivation of Liberty Safeguards (DoLS) remained unclear. Despite this the registered manager had taken steps to ensure that DoLs was understood by staff and applications made where needed.

There was a positive, open and inclusive culture in the service. The atmosphere in the service was warm and welcoming. People received care that was personalised to them and met their needs and wishes.

There were sufficient numbers of staff to meet people’s needs. Recruitment processes checked the suitability of staff to work in the service. Staff respected people’s privacy and dignity and interacted with people in a caring and compassionate manner.

Staff understood the importance of gaining people’s consent and people were involved in making decisions about their care.

People presented as relaxed and at ease in their surroundings and told us that they felt safe. Procedures were in place which safeguarded the people who used the service from the potential risk of abuse.

People were complimentary about the staff and management team. Staff were compassionate, attentive and caring in their interactions with people. They understood people’s preferred routines, likes and dislikes and what mattered to them I

Independence, privacy and dignity was promoted and respected. Staff took account of people’s individual needs and preferences

People’s nutritional needs were assessed and professional advice and support was obtained for people when needed. People were supported to see, when needed, health and social care professionals to make sure they received appropriate care and treatment.

People were provided with their medicines in a safe manner. They were prompted, encouraged and reassured as they took their medicines and given the time they needed.

A complaints procedure was in place. People were asked for their views about the service and their comments were listened to and acted upon.

There was a registered manager in post. 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.

People were involved in decisions about how they were supported outside of the service. However, the provider’s guidelines relating to the Deprivation of Liberty Safeguards (DoLS) were out of date. Without up-to-date policies and guidance from the provider, the management and staff at the service could not be sure that they were making appropriate decisions to ensure relevant safeguards were in place to protect people who may be deprived of their liberty.

People received care that was personalised to them and met their needs and wishes. Staff listened to people and acted on what they said. The atmosphere in the service was relaxed and welcoming.

Feedback from people about the staff and management was positive.

Procedures were in place which safeguarded the people who used the service from the potential risk of abuse. Staff understood the various types of abuse and knew who to report any concerns to.

Staff knew how to minimise risks and provide people with safe care. Procedures and processes guided staff on how to ensure the safety of the people who used the service.

People were provided with their medicines when they needed them. However, some people were taking their medicines mixed with food without consultation from a pharmacist to ensure it would not compromise the medicines safety or effectiveness.

There were sufficient numbers of staff to meet people’s needs. Recruitment processes checked the suitability of staff to work in the service. People were treated with kindness by the staff. Staff respected people’s privacy and dignity and interacted with people in a caring and compassionate manner.

Staff were trained and supported to meet the needs of the people who used the service. People’s nutritional needs were assessed and met. People were supported to see, when needed, health and social care professionals to make sure they received appropriate care and treatment.

A complaints procedure was in place. People’s comments, concerns and complaints were listened to and addressed in a timely manner.

There was an open and transparent culture in the service. Staff were aware of the values of the service and understood their roles and responsibilities in providing safe and good quality care to the people who used the service.

The service had a quality assurance system in place which was used to identify shortfalls and to drive continuous improvement. However, these systems had failed to identify where guidance and practice were out of date in some areas as well as where improvements were needed to the care records.

Is the service safe?

We saw that the provider had made improvements to the environment following our last inspection where they were found to be non-compliant. People had been cared for in an environment that was safe, clean, hygienic and well maintained.

We saw that care plans were sufficiently detailed to allow staff to deliver safe and effective care that reflected the support required for people's assessed needs.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). This is where restrictions may be placed on some people to help keep them safe. While no DoLS applications had needed to be submitted, we found that suitable policies and procedures were in place. Relevant staff had been trained to understand when an application should be made and how to submit one.

Is the service effective?

We asked two people if they were happy with the support they received. They told us that they were and felt that their support needs had been met. One person commented "It's good living here, I love it". Our observations and discussions with staff showed that they had a good understanding of people's care and support needs and that they knew them well. This was reflected by the clear guidance in people's care plans and the support staff provided.

Is the service caring?

We asked people who used the service if staff were kind and gentle when they supported them. People told us that they were. One person said "All of the staff are great.' Care records contained personalised information which helped staff to know the people they supported and how to meet their needs. We saw that staff showed patience, compassion and understood how to support people as individuals. Our observations found that staff knew how to communicate effectively with people. We saw that staff sometimes used hand signs and picture reference cards to help them do this.

Is the service responsive?

People's needs had been assessed before they moved to Parkdale. This meant the manager could be certain that the service had the skills and facilities to meet the identified needs of the people who lived there. People told us that they met with their key workers at least once a month to talk about the things that were important to them. People had access to activities that were important to them and had been supported to maintain relationships with friends and relatives where possible. Records confirmed that people had access to other health care professionals. This meant that there was access to specialist help when needed.

Is the service well-led?

Staff had a good understanding of their role within the service and felt supported by the manager who ensured that they received regular supervision and access to training to enhance their professional development. The manager showed a good knowledge and oversight of the running of the service. There were quality assurance processes in place to maintain standards in the service. We saw that staff and people who used the service had been given opportunities to express their views about how it was run.

Throughout the inspection, the manager and staff demonstrated that they placed the needs of the people who lived at Parkdale at the heart of the service. Discussion with staff found that they had a good understanding of their responsibilities and of the values of the service.

Medication was safely managed. Staff were robustly recruited and there was a suitable complaints system in operation that met people's needs. Whilst this was an appropriate community based living service it could be a better maintained environment.

We found that staff were appropriately trained and sufficiently supported to deliver care and support safely. The quality and safety of the service was regularly assessed and monitored to ensure the health, safety and welfare of people using the service and make improvements where necessary.