Parkhouse Manor Care Home Care Home Service 557 Parkhouse Road Barrhead Glasgow G78 1TE Telephone: 0141 881 7823 Type of inspection: Unannounced Inspection completed on: 6 June 2017 Service provided by: Laurem Care Group Limited Service provider number: SP2014012402 Care service number: CS2014333774
About the service We undertook an unannounced inspection to the service on 29 and 30 May and 6 June 2017. We spent time speaking with residents, relatives and staff and we sampled paperwork. We spoke with as many staff as we could including the manager, the providers, nursing and care staff, maintenance and housekeeping, catering and activity staff. We also spoke with a visiting Care Home Liaison Nurse. Parkhouse Manor Care Home is registered to provide nursing care and support for up to 48 older people. The provider is Laurem Care Group and they commenced the ownership of the home in June 2015. There were 46 people living in the home during the inspection. The service is based in two separate traditional dwellings (Oakview and Beechview). The new providers have made considerable progress with the refurbishment of the home. The care home has a car park to the front and large enclosed gardens and patio area to the rear which provides a pleasant and private space for residents. The home is situated in a rural area just outside Barrhead and there are shops and other facilities a short journey away. The philosophy of care for Parkhouse Manor Care Home is 'We believe that people who choose our home have an absolute right to live as they wish, but always with dignity, respect and warmth'. What people told us We spoke with 19 residents and four sets of relatives during the inspection and we also joined residents in a variety of activities and settings such as the dining experience and carpet bowls. We received the following comments from residents:- 'The staff make this a warm and friendly place.' 'My Keyworker is very good.' 'I'm very happy, it's all very good.' 'Care is top-notch, staff are great, I would like more alcohol.' 'I'm quite content, there is not a lot I ask for.' 'I am fine, the staff are nice.' 'I am bored. I need more to do. Staff are kind and caring.' 'I like the company, the girls are good.' 'It's nice here. I enjoyed my lentil soup today.' We received the following comments from relatives:- 'Delighted with the care for mum.' 'I would absolutely say if anything was wrong. Girls are great.' 'We feel mum is well looked after.' 'There is good communication with staff.' 'I am extremely happy with the care provided by the home. The staff keep me informed and they are welcoming of my family. Staff give my relative lots of time and patience. I feel reassured that my relative is cared for in a clean, loving environment by lovely, professional staff.' page 2 of 9
Self assessment N/A From this inspection we graded this service as: Quality of care and support Quality of environment Quality of staffing Quality of management and leadership not assessed Quality of care and support Findings from the inspection During this inspection we found that staff knew the residents well and supported them with patience, warmth and kindness. We received positive comments about the care and support from both residents and their relatives. Residents and relatives told us that they were 'happy' with the care and support provided and residents felt 'safe and well cared for.' We sampled care plans from the two 'houses'. We found that they were still clinical in tone and did not fully reflect the person centred practice we could see that staff delivered. Most of the care plans were up to date and accountable, however we did see some that required attention. We could see some person centred recordings in daily notes but also a frequent use of 'no changes.' The review minutes needed to be positive and outcome focussed. They were mainly of a poor quality and were not reflective of how the resident had lived their life in care home. We discussed this with the management team and they assured us that the care plans would be a priority. This recommendation will continue. We also looked at the Adults With Incapacity paperwork and found that the treatment plans to support residents were sporadic. We asked the service to address this as a matter of urgency and by day three of the inspection, they had actively been discussing this with the relevant G.P.'s We sampled aspects of medication practice. We found that the medication system was accountable and the MAR sheets were completed. We looked at care plans for residents who may require PRN (as required) psycho-active medication. We did not find that the care plans recorded enough detail about when the medication would need to be given and why. This will be a recommendation. We observed the breakfast and lunchtime experience in the dining areas and found the experience to be pleasant for residents. The atmosphere within the dining areas was relaxed and residents were being supported to eat their meals. The chef had consulted with residents and their views would inform the new menus planned. We discussed the need for 'finger food and snacks to be readily available, particularly for those residents who liked to be able to walk freely around the home. page 3 of 9
There was a new activities staff member and she was still getting to know residents. We thought that the activities needed to be more responsive to the preferences and interests of residents and that the activities worker would benefit from more training. This was discussed with them and the manager and they agreed. We did see residents participate in activities they enjoyed such as bingo, carpet bowls and singing however this area should be developed more. We looked at the way that residents' personal money had been managed. The records we looked at also showed that staff kept accountable records and receipts to evidence that residents' finances had been managed properly. We could see that residents were supported, where appropriate, to enjoy their money by doing things that they enjoyed or buying a small piece of equipment such as a new television. Requirements Number of requirements: 0 Recommendations Number of recommendations: 2 1. Care plans for residents were clinical in information and tone. Staff should develop the care plans to promote a more person centred style of recording. National Care Standards for Care Homes for Older People Standard 6 Support Arrangements. 2. The care plans for residents who may need PRN medication should be developed more fully to address such as triggers, what else may work, the effect of the medication and the outcome for the resident. National Care Standards for Care Homes for Older People Standard 15 Keeping well - medication. Grade: 4 - good Quality of environment Findings from the inspection We walked around the home when we arrived to introduce ourselves and get a view on the environment. We found that the home was warm, well-decorated and offered a good variety of areas for residents to relax in. Some residents invited us into their bedrooms and we saw that the rooms were personalised and reflected individual tastes and preferences. We spoke with housekeeping staff and they told us that they had plenty of equipment to keep the home clean and infection free. The refurbishment plan was progressing well and the interior of the home now offered a good 'blank canvas' for the home to consider how to decorate and furnish the home to support residents with a diagnosis of dementia. We walked around the home with the one of the providers and the manager and discussed the findings. The requirement regarding sending the Care Inspectorate regular refurbishment plans has been met but will continue as a recommendation. page 4 of 9
When we walked around the home we pointed out areas that required attention. We saw a few infection control concerns and we found that the cupboards were stocked with items that should not be there such as continence products with no names on them. We asked the manager to address these concerns and they had been attended to on day three of the inspection. It was recommended to the home that they draw up an action plan arising from their own findings of the Kings Fund Audit. This audit is a tool to assist care homes to ensure that their environment is a good as it can be for residents living with dementia. The gardens were a feature that were complimented by residents and relatives. There were several areas to sit and interesting features for residents to enjoy. We checked the maintenance records and found them to be accountable. The maintenance staff member we spoke with was very clear about his responsibility to keep the home safe for residents. Requirements Number of requirements: 0 Recommendations Number of recommendations: 2 1. The home should continue to send their refurbishment programme to the Care Inspectorate. National Care Standards for Care Homes for Older People Standard 4 Your environment 2. The service should draw up a plan outlining the action to be taken in response to the Kings Fund Audit recently undertaken. National Care Standards for Care Homes for Older People Standard 4 Your environment Grade: 4 - good Quality of staffing Findings from the inspection We spoke with as many staff as we could, across all departments including night staff. They told us that they 'loved coming to my work' and 'my job is great.' We received positive comments about the staff from residents and relatives. They told us that staff were 'lovely' and 'so kind'. Staff told us that they 'enjoyed their job' and 'loved the residents'. We spent time with staff observing their practice and discussing their training and support within the home. When we spoke with staff we could see that they were committed to offering good, safe care to residents. They told us that they received good training opportunities and they felt well supported by the management team. Most of the training offered by the home was an e-learning programme called 'Strategic Thinking'. We discussed page 5 of 9
the need for staff to also participate in experiential training. We saw the training plan and could see that staff had completed other training topics such as fire safety, moving and handling and dignity in care. We did feel that staff would benefit from more training in the field of Adult Protection as some staff were vague when asked about this. This will be a recommendation. We looked at dementia training for staff. The service was progressing well in ensuring that staff had the appropriate training for their role. This ensured that residents living with dementia were cared for by skilled and experienced staff. We discussed the need for staff to record in care plans in a more person centred way. They could tell us verbally how they cared for residents but this was not reflected when staff wrote in care plans. This will be developed and discussed by the management team. We could see that the home kept accountable records for the professional registrations of all staff, where appropriate. We saw that staff were all registered with the appropriate professional body and that the home actively encouraged and supported them to achieve the qualification required to be registered. The new manager was commencing the SVQ IV to support her in her managerial role. We asked about staff supervision and were advised that it was 'variable'. We discussed the need for all staff to receive regular, formal supervision to support them and their personal development. This will be a recommendation. We discussed with the manager about more formal training for activity staff. It was agreed that this would be put in place. This will be a recommendation. Requirements Number of requirements: 0 Recommendations Number of recommendations: 3 1. Staff would benefit from a more organised and responsive approach to training, particularly in the area of adult protection. National Care Standards for Care Homes for Older People Standard 5 Management and staffing arrangements. 2. Staff should receive regular, formal supervision in line with company policy. National Care Standards for Care Homes for Older People Standard 5 Management and staffing arrangements. 3. The activity staff member would benefit from formal training in the provision of activities to respond to the interests and preferences of residents. National Care Standards for Care Homes for Older People Standard 5 Management and staffing arrangements. Grade: 4 - good page 6 of 9
Quality of management and leadership This quality theme was not assessed. What the service has done to meet any requirements we made at or since the last inspection Previous requirements Requirement 1 The provider must comply with the refurbishment plan agreed at registration and this must be displayed. This plan must be reviewed withinsix months of registration and the provider must inform the Care Inspectorate of progress. This is in order to comply with SSI/2011 Regulation 10.2 (a),(b),(c) and (d) Fitness of Premises. This requirement was made on 17 November 2015. Action taken on previous requirement The home was still in the process of being refurbished. Very good progress was being made. It will become a recommendation that the home continue to keep us updated on the refurbishment programme. Met - within timescales What the service has done to meet any recommendations we made at or since the last inspection Previous recommendations Recommendation 1 Daily notes should reflect the residents whole day not just the personal care undertaken. They should reflect what the person did that day and if they enjoyed the experience. Daily notes should not only be used to record clinical interventions or 'settled day'. This recommendation was made on 17 November 2015. page 7 of 9
Action taken on previous recommendation This recommendation has not been met. At this inspection we found that the care plans and daily notes were not person centred, they were still clinical in tone. Recommendation 2 Each staff member should have their own individual training plan and record of training. They should be responsible for updating this when they have attended a course. This recommendation was made on 9 May 2016. Action taken on previous recommendation This recommendation has been met. We saw that each staff member had their own training plan. Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at www.careinspectorate.com. Enforcement No enforcement action has been taken against this care service since the last inspection. Inspection and grading history Date Type Gradings 9 May 2016 Unannounced Care and support Environment Staffing Management and leadership 17 Nov 2015 Unannounced Care and support 3 - Adequate Environment 3 - Adequate Staffing 3 - Adequate Management and leadership 3 - Adequate page 8 of 9
To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and help services to improve. We also investigate complaints about care services and can take action when things aren't good enough. Please get in touch with us if you would like more information or have any concerns about a care service. You can also read more about our work online at www.careinspectorate.com Contact us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com 0345 600 9527 Find us on Facebook Twitter: @careinspect Other languages and formats This report is available in other languages and formats on request. Tha am foillseachadh seo ri fhaighinn ann an cruthannan is cànain eile ma nithear iarrtas. page 9 of 9