Care and Social Services Inspectorate

Care Standards Act 2000

Inspection Report

Stradey Park House

61 New Road SA15 3DP

Type of Inspection – Baseline Date(s) of inspection – 13 September 2013 Date of publication – 18 October 2013

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Please contact CSSIW National Office for further information Tel: 0300 062 8800 Email: [email protected]

www.cssiw.org.uk Summary

About the service Park House is registered as a care home to provide care for younger adults who have a learning disability and require assistance with personal care; it can accommodate no more than seven people. . A variation to the registration is in place to allow one named older person with a mental health problem and one named younger adult with a mental health problem. There were five people living in the home at the time of the inspection visit.

The home is situated in a quiet residential area within walking distance of Llanelli town centre with many shops and facilities, including public transport.

The home is owned by Care Homes Limited. The responsible individual for the company is Mrs. Patricia Williams. The registered manager Rachel Edwards has day to day responsibility for the home.

Of the five service users residing at Stradey Park House four have resided at home for some years. The most recent service user has been living at the home for the past two weeks. Residents were seen as happy and were engaging in the inspection process.

What type of inspection was carried out? This was a scheduled baseline inspection, conducted on the 13 September 2013, and focussed on the quality of life for service users, together with the quality of staffing, leadership and management and the environment in which people live.

Information was gathered for this inspection following scrutiny of the returned self assessment of service and annual data collection documents as well as information held by CSSIW. People living at Stradey Park House and the manager/staff were spoken with. Documentation maintained within the home was observed as was the environment in which people live.

What does the service do well?  The manager and staff know the people who use the service very well and are therefore able to offer individualised personal care.  The service is responsive to the changing needs of the people who use the service.  The service offers a homely and comfortable environment for people to live in.

What has improved since the last inspection?  The office space has been reorganised and there is a renewed filling system which providers a simpler, efficient way to access records.

What needs to be done to improve the service? No compliance issues were identified.

The following recommendations and notifications were made: We notified the registered manager that they were not compliant with the following Version 1.1 07/2012 regulations:

Regulation 15 (1) there was no written plan as to how the recently admitted service user’s health and welfare needs were to be met.

Regulation 19 (2) (d) fitness of workers. Staff files lacked appropriate proof of identification.

Regulation 13 (2) suitable arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines received into the care home.

Regulation 12 (1) (a) to make proper provision for the health and welfare of service users. It was recommended that a policy is in place for staff to adhere should emergencies/issues occur during the night.

The above issues have satisfactorily been address following inspection and prior to report writing.

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Quality of life

People who use the service feel listened to and believe that their views are valued. They indicated that they feel confident in raising any issues with the manager or staff at any time and they freely interacted and contributed to discussion. This was also evidenced in the records of the six monthly house meetings in which actions had been taken following service user suggestions such as new handrails on the stairs. People are clearly given choice and are able to influence all aspects of their lives, and described how they contributed to meal choices, shopping, activities undertaken both within and outside the home. Service users demonstrated throughout the inspection that they felt recognised and valued by the registered manager and the staff.

People living at Stradey Park House are active, positively occupied and stimulated. The current service users are encouraged to access opportunities to learn and to follow individual interests which they might have, both within and outside of the care home. They access a variety of local drop in centres such as FAB, Breakthrough, and Gateway Clubs with staff support. People are given a choice about what activities they wish to engage in. In addition to the structured weekly time table of activities, people are supported to access the community with support whether this is to go out for lunch, play snooker, and watch a rugby match or other events. Two of the service users will be going to overnight and are looking forward to seeing a Michael Jackson show in October 2013. Staff have developed a good understanding of the needs and preferences of the service users.

A sample of care plans and risk assessments were examined. The ‘My Plan’ of service users who had been at the home for sometime were detailed, person centred and reviewed appropriately, files included numerous photographs of the individual engaging in different events and activities. The care plans had been developed over time and added to when necessary. The care file of the latest person admitted however, lacked a care plan and risk assessments devised by the home to support staff in delivering care to meet the individuals identified care needs. This has been address and care plans and risk assessments for the individual have been forwarded following inspection.

Service users are encouraged to look after themselves and are supported to be fit and well. Close and regular contact is maintained with all relevant health and social care professionals, as documented in the files of each service user. Discussion with the manager and observation of service user records indicates that any change to the health of the service users receives prompt and appropriate response.

Service users experience enhanced wellbeing because the service anticipates their needs and are proactive in addressing potential needs. This was evidenced through discussion with the manager who informed about research undertaken with regards to the effects of Huntington’s Disease, such as early trigger signs and training for Epilepsy which staff will be undertaking despite no residents currently experiencing.

People who use the service cannot be confident that they are safe from potential medication errors. This was because suitable arrangements for the recording and safe administration of medication were not in place. It was observed that the Medication Administration Sheets needed brining in line to reflect the actual date of medication given. The home administers a new medication pack on a Monday however, the pharmacist sheet reflects a start date as a Friday. As such medication given today was recorded on the MAR’s sheet three days earlier which could potentially lead to

4 Version 1.1 07/2012 medication errors. Following the inspection this was addressed immediately and the manager provided assurances to CSSIW that the pharmacist has adjusted the MAR’s sheets to reflect the correct date.

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Quality of staffing

People living at Stradey Park House experience a strong sense of belonging and have forged close relationships with the staff working there. This was evidenced from the observations of staff and service user interaction. Service users are cared for by motivated and familiar staff, who actively engage with them and want to make a positive contribution to their lives. Their needs are anticipated and people benefit from good, timely decisions and responsive care. Staff spoken with were enthusiastic about their involvement with service users, and demonstrated a good knowledge of their individual needs and preferences. A key worker system is in place and every effort is made to match the service user with a staff member of similar interests. One staff member was obviously passionate and proud about his work, he informed that he support one service user to attend every home game the Scarlett’s play regardless if he is on shift or not. The service user was described as being ‘one of the boys’ and ‘knows more people than me’, it was evident that the service users had an enhanced wellbeing due to the commitment displayed by the staff members working at the home. The same service user plays for a rugby team and has previously been fortunate to go on tour with staff support. It was evidenced from staff meeting records that both staff and management are supportive of their service users with management approaching Asda for the possibility of sponsorship to enable a future rugby tour to New Zealand.

Staff, demonstrated that they knew the service users very well, service users spoke very highly of the care they received and of the way in which they are treated at Stradey Park House. The atmosphere within the home is relaxed and informal and care is offered in a calm and unhurried manner. Service users have very good interactions with staff and the manager.

People could not be assured that staff files contain the necessary documentation. A random selection of personnel files were examined and were found to be lacking proof of identification. However, this was addressed immediately with the staff members on duty providing their drivers licence for photocopying and inputting into the staff files. There was evidence of regular and robust staff supervision occurring two-monthly in line with the National Minimum standards. It is recommended that it is documented as to why supervision has been delayed i.e. due to annual leave or staff sickness on occasions when this occurs. There were sufficient staff on duty during the inspection to meet the needs of the people living in the home. Staff were observed as being courteous and respectful to service users.

Staff receive mandatory and update training on a regular basis and are able to cope with the more complex demands made by service users. Training is provided by County Council, the local Community Learning Disability Team and also a private training consultant. The training matrix was updated and forwarded following inspection which highlights all training is up to date.

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Quality of leadership and management People who use the service are clear about what it sets out to provide. The Statement of Purpose indicates the type of care and support that is provided at Stradey Park House. People spoken with during the inspection said that they receive good support from a service that can meet their needs effectively.

People receive effective support from a service which can fully meet their needs; this is because overall we found that the service has been well designed to meet people’s needs. Good quality care is provided and there is effective management. People using the service, working in the service or linked to the service are clear about what it sets out to provide.

The registered manager possesses the relevant qualifications and is registered with the Care Council for Wales. Discussion evidenced that she had a good knowledge and understanding of care home management and in particular the needs of those living within the home. People can be confident that the registered manager intends to continue to improve the service provision.

Staff spoken to said that the management structure generally provided good leadership at the care home, were accessible and easy to approach.

People can be confident that they receive good quality care this is because the business is well run, with due care and attention to minimum standards and regulations. This is due to the fact that they have suitable policy and procedures in place and maintain good records including an annual quality assurance report. We saw well documented records maintained in accordance with the regulations and standards. It was recommended that a policy was put in place for staff to adhere to should emergencies/issues occur during the night as there is one wakeful staff member. Following inspection and prior to report writing this policy has been developed and is now in place.

No written complaints have been made since the last inspection. There is a system for logging complaints.

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Quality of environment People who use the service feel safe and comfortable at Stradey Park House and are reassured by an environment which offers a sense of homely familiarity. Service users clearly feel a sense of belonging and ownership of their own rooms and of the home in general.

The current service users, following risk assessment, access the local community with staff support if identified. The home is located within the town of Llanelli and service users can therefore visit shops, cafes and other community facilities which are within walking distance.

Service users’ rooms reflect individual personalities and interests. They are spacious and comfortable, providing an area in which service users can relax, watch television, listen to music or pursue hobbies and interests. People could be assured that the environment is kept clean and well maintained. People using the service were cared for in a comfortable suitable environment, which is suitable for their needs.

People living at the home can be assured that they will be safe in their environment because there are regular health and safety checks. We looked at a random sample of certificates and found that all the checks had been completed including electrical and fire safety checks.

People can be assured that their personal information is secure because we saw that records were stored in a locked cabinet.

We saw a book to record all visitors to the home as a means of promoting the safety of the people staying there.

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How we inspect and report on services We conduct two types of inspection; baseline and focussed. Both consider the experience of people using services.

 Baseline inspections assess whether the registration of a service is justified and whether the conditions of registration are appropriate. For most services, we carry out these inspections every three years. Exceptions are registered child minders, out of school care, sessional care, crèches and open access provision, which are every four years.

At these inspections we check whether the service has a clear, effective Statement of Purpose and whether the service delivers on the commitments set out in its Statement of Purpose. In assessing whether registration is justified inspectors check that the service can demonstrate a history of compliance with regulations.

 Focussed inspections consider the experience of people using services and we will look at compliance with regulations when poor outcomes for people using services are identified. We carry out these inspections in between baseline inspections. Focussed inspections will always consider the quality of life of people using services and may look at other areas.

Baseline and focussed inspections may be scheduled or carried out in response to concerns.

Inspectors use a variety of methods to gather information during inspections. These may include;

 Talking with people who use services and their representatives  Talking to staff and the manager  Looking at documentation  Observation of staff interactions with people and of the environment  Comments made within questionnaires returned from people who use services, staff and health and social care professionals

We inspect and report our findings under ‘Quality Themes’. Those relevant to each type of service are referred to within our inspection reports.

Further information about what we do can be found in our leaflet ‘Improving Care and Social Services in Wales’. You can download this from our website, Improving Care and Social Services in Wales or ask us to send you a copy by telephoning your local CSSIW regional office.

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