Parkhaven@Home

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and 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.

People's needs were assessed and recorded by suitably qualified and experienced staff. Support was delivered in line with current legislation and best practice. Risk assessments and support plans had been completed for everyone who was receiving care to help ensure people's needs were met and to protect people from the risk of harm.

People's preferences had been recorded in respect of personal care routines and likes and dislikes for food and drinks. Allergies and other medical information was also recorded.

Staff had been appropriately checked when they were recruited to ensure they were suitable to work with vulnerable adults. The service ensured that staff were trained to a high standard in appropriate subjects.

Staff understood how to recognise abuse and how to report concerns or allegations.

The records we saw indicated that medicines were administered correctly and were subject to regular audit.

There were appropriate numbers of staff employed to meet the needs of people who received a service and to ensure they received the support at a time when they needed it.

Policies and procedures provided guidance to staff regarding expectations and performance. Staff were clear about the need to support people's rights and needs regarding equality and diversity.

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 supported this practice. We saw clear evidence of staff working effectively to deliver positive outcomes for people.

People we reviewed were receiving effective care and support. They gave positive feedback regarding staff support.

People told us that staff treated them with kindness and respect. Our observations confirmed this. Support was provided in accordance with people's assessed needs. Relatives said their family members were supported by staff to take regular holidays and enjoy their favourite activities.

People using the service, their relatives and staff were asked to share their views. They provided very positive responses regarding the support provided.

There was a complaints process. No complaints had been received.

People spoke positively about the management of the service and the approachability of the staff. There was clear management structure that supported staff. The registered manager was aware of their responsibility to notify the Care Quality Commission of certain incidents and has submitted notifications to meet this requirement. The ratings from the last inspection was displayed at each location and on the registered provider's website, as required.

Further information is in the detailed findings below.

Parkhaven@home domiciliary care service was set up by the Parkhaven Trust in April 2008. The service is based at the Administration Department within the Parkhaven Trust estate. The service supports people in their own homes and within extra care housing schemes. It provides a wide range of services to support people living with dementia, older people and people with learning or physical disabilities. There were 31 people receiving a domically service from Parkhaven@home during our inspection. Nine people were receiving support over a 24 hour period in one scheme, Deyes Lane, 20 people were receiving a ‘drop in’ service from staff who were based at Parkhaven Court which is comprised of 24 self-contained flats and a communal area, and two people who lived in their own home received two hours per week support from staff.

There was a manager in post, and they were in the process of becoming registered.

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 and family members told us they felt safe with the level of care being provided by Parkhaven@home.

Staff knew what actions to take if they thought that anyone had been harmed in any way. Relatives told us they were happy with the care their family member was receiving.

Recruitment procedures were robust to ensure staff were suitable to work with vulnerable people.

People were supported to contact the housing provider when needed to ensure checks on their home were completed in line with their tenancy agreements. This included health and safety checks of the equipment and building.

People received their medicines as prescribed and safe practices had been followed in the administration and recording of medicines.

Relatives we spoke with confirmed that there were enough staff available to meet the needs of the people using the service.

Risk assessments were clear and contained an appropriate level of detail. Staff demonstrated they were able to support people in accordance with their plan of care.

Staff understood the need to respect people’s choices and decisions if they had the capacity to do so. Assessments had been carried out and reviewed regarding people’s individual capacity to make care decisions. Where people did not have capacity, this was documented appropriately and decisions were made in their best interest with the involvement of family members where appropriate and relevant health care professionals. This showed the provider understood and was adhering to the Mental Capacity Act 2005. This is legislation to protect and empower people who may not be able to make their own decisions. Where appropriate we saw that applications had been to the Court of Protection.

People were supported to purchase and prepare the food and drink that they chose. People and their relatives had been involved in the assessment and planning of their care. Care records were detailed and gave staff the information they required so that they were aware of how to meet people’s needs.

There was a complaints procedure in place and people felt confident to raise any concerns either with the staff, the scheme leader or manager

Staff were trained in accordance with the service’s training policy, and completed a work based qualification following a successful probationary period.

Staff said they benefited from regular one to one supervision and appraisal from their manager.

There was a safeguarding and a whistleblowing policy in place, which staff were familiar with.

Quality assurance audits were carried out and feedback was collected regularly from staff, relatives and people using the service. These were analysed and responded too appropriately. We could see the manager was using this feedback to continuously improve the service offered.

Other quality assurance audits we saw were highly detailed and encompassed CQC’s own guidance for providers with meeting the ‘KLOE’s (key lines of enquiry).

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

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

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

Is the service safe?

People were treated with respect and dignity by the staff. People told us they felt safe and well cared for.

Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduces the risks to people and helps the service to continually improve. Some of these systems have been developed and improved since the last inspection.

The service had some supporting policies and information around mental capacity and consent to support people who may not be able to make decisions about their care or support. The manager reported there had been training in this area but it was very limited. None of the staff we spoke with had received any updates or training in the workings of the Mental Capacity Act 2005, which is the legislative framework for the decision making process regarding people who may lack mental capacity. We spoke with the manager about the development of staff knowledge in the field of dealing with people who lacked capacity to make decisions and particularly knowledge and awareness regarding the MCA 2005.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People said that the care plans reflected their current needs.

We were told by people and their relatives that the model of care provided supported people well and gave them a degree of autonomy and independence.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. Staff had a good rapport with people and understood their care needs. People commented, 'It's excellent here. The good thing is that I don't worry and we have a decent quality of life. It's comforting to know there is always staff on hand.' A person receiving support said, 'The care staff are very good. They are always popping in to see how I am. They are always there when I need anything.'

People using the service and their relatives completed an annual satisfaction survey. We saw the feedback was good with positive comments recorded. For example, 'Staff work as a cohesive team,' 'safe environment,' 'Nothing seems too much trouble.'

People's preferences and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

We saw that people were supported to complete a range of daily activities and this included support with social activities. People were supported as their care needs changed. This was particularly evident with changing medical and care needs. We saw at one part of the service that people were supported with a range of social activities.

Following our last inspection in January 2014 we had made some compliance actions [requirements] that the service needed to respond to and address. We found that these had been addressed and the improvements made. For example, care records were now more detailed and individualised and medication administration was safer because there were clearer records that could be checked and monitored.

Is the service well-led?

The service had a quality assurance system. Records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the service and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.

People who used the service were not protected against the risks associated with the unsafe use and management of medicines. This was because there were not appropriate arrangements in place for the recording, handling, using and safe administration of medicines used for the purpose of the regulated activity.

We looked at the personnel files of two people who worked for Parkhaven@home. We saw that the provider had effective recruitment procedures in place to check that people were of good character, suitably qualified and fit to work for the purposes of carrying out regulated activity.

There were not effective systems in place to identify risks to health, welfare and safety. We looked at the care records of three people who used the service and found a number of omissions and inaccuracies that had not been identified

The provider had an effective complaints procedure in place.

The provider did not maintain accurate records in relation to the care and treatment provided to people using the service.

Parkhaven@home provides twenty four hours a day domiciliary care to Parkhaven Court which is a supported housing scheme and Deyes Lane which is a supported tennency scheme and has a limited number of service users in the community.

People told us:

"This is the closest thing to living independently you could do, you just get help when you need it not when someone wants you to have it"

"I've lived within a Parkhaven facility for thirty five years and this is the best "

"I used to live in a nursing home and everyone did everything for me now here I look after myself and the girls help when I need them"

'A safe, secure, happy home environment.'

'Staff are very helpful and kind to my Mum. She has her bad days but they all look after her very well.'

'The staff are amazing; nothing is too much trouble for them. They are a credit to the Trust. It is very difficult placing relatives in any kind if care, to find a place like this is a worry taken away. The staff are pleasant, they never stop and are worth their weight in gold! They have become friends

Staff told us:

"I love it here I go home feeling i've helped someone to retain their independence and be happy"

"Its not like coming to work its like walking down your street at home and dropping in on all your neighbours to make sure they are ok"