Archived: Parkhouses Independent Living Services

Parkhouses Independent Living Services is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. Not everyone using Parkhouses Independent Living Services receives a regulated activity. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

At the time of our inspection the service was providing personal care to 14 people. Four of the people supported lived in a shared house with 24-hour support from care staff.

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 and their relatives were involved in discussions and decisions about the care and support needed and they could influence the delivery of their care. People were supported to have maximum choice and control of their lives and their healthcare needs were monitored as appropriate. However, people’s ability to make decisions had not been formally assessed or documented to show which decisions they could or could not make. Improvements were required to the processes for assessing people’s mental capacity. We made a recommendation about mental capacity assessments.

People who used the service and their relatives told us they felt safe when staff members were in their homes. Staff had received training in safeguarding and knew their responsibilities to report any concerns. The service also had whistleblowing and lone working policies in place.

Risk assessments were in place to keep people safe. These were reviewed and updated regularly or when changes occurred.

Recruitment systems and processes in place were robust. We saw references, identity checks and Disclosure and Barring Service checks were completed before staff were employed.

New staff members were expected to complete an induction when they commenced employment. Training courses were available to staff which were relevant to their roles. Staff members told us, and records confirmed, that staff members received supervision and appraisals on a regular basis. Staff members we spoke with told us they were able to discuss any training requirements they had.

Our observations and feedback provided by people showed that staff were kind, caring and supportive of people who used the service.

The service delivered person centred care. We saw person centred care plans were in place and reviewed regularly.

The service had a complaints procedure in place. One complaint had been received since our last inspection.

Accidents and incidents were reported to management. This meant they were able to see if appropriate action had been taken by staff to ensure people were kept safe.

The registered manager had processes and systems in place to monitor and improve the quality of the service.

We saw regular staff meetings were also held. Staff told us they were able to bring up topics for discussion.

The service was meeting all relevant fundamental standards.

Further information is in the detailed findings below.

We last inspected the service 26 June 2013 and found the service was meeting the regulations that were applicable at that time.

Parkhouses Independent Living Service provides a flexible 24 hour personalised care and support service for people who require support to live independently within the community. Additional services are offered such as domestic support and carer support. The office is located near the centre of Burnley, Lancashire. At the time of the inspection 10 adults with a learning disability or autistic spectrum disorder were using the service.

People spoken with were complimentary about the care and support provided and about the staff team. They told us, “I like all the staff who work in my house.” And I like my staff; they help me decide what I want to do.” Quality assurance monitoring surveys showed people consistently received excellent care and support from staff employed by the agency.

There were good systems and processes in place to keep people safe. Staff had an excellent understanding of risk management. Risks to people had been identified, assessed and managed safely. People were encouraged to live their lives the way they chose, but supported to recognise this should be done in a safe way. The service liaised with other service sector professionals such as the fire authority who offer a free fire risk home assessment and liaised with landlords to ensure the safety of people’s homes.

People told us they felt safe in their homes when staff visited. Arrangements were in place for staff to gain entry to their home according to people’s wishes. People had a direct telephone link to the office they could use for emergencies. People told us staff were respectful towards them and their property. The agency had a code of conduct and practice staff were familiar with and expected to follow when visiting people in their homes. This was monitored closely.

People were cared for by staff that had been recruited safely and were both trained and receiving training to support them in their duties. People using the service were involved in recruiting their own staff and providing induction training when they started work. Staff training was thorough and all staff held a recognised qualification in care. We found there were sufficient numbers of suitably qualified staff to attend to people’s needs and keep them safe. Staff were trained in emergency procedures.

People’s medicines were managed safely and were administered by staff who were trained and competent.

Staff received a range of appropriate training to give them the necessary skills and knowledge to help them look after people properly. This helped to ensure the staff team had a good balance of skills and knowledge to meet the needs of people using the service. Staff were very well supported by the management team and received regular supervision.

The registered provider and staff understood their responsibilities in promoting people's choice and decision-making under the Mental Capacity Act (MCA) 2005. Staff followed the principles of the Mental Capacity Act 2005 to ensure that people’s rights were protected. People were very well supported in decision making and decision making tools were used to help people remove barriers that prevented them doing what they wanted to do and remain independent.

People’s nutritional needs were met and they were involved in menu planning, shopping for food and basic food preparation. Healthy options were promoted.

People’s individual needs were assessed and support plans were developed to identify what care and support they required. People were regularly consulted about their care to ensure their wishes and preferences were met and their independence was promoted. Staff were knowledgeable about people’s individual needs, backgrounds and personalities and worked with health and social care professionals involved in people’s care and support. Staff supported people to maintain their relationships with their friends and relatives.

People told us staff acknowledged they were working in their home and treated their visits as such and respected their privacy. They knew what staff could and could not do. This was explained to them in their information guide they received which was in a format suitable for their understanding. This meant people’s expectation about the service they received was what they wanted and what was right for them.

People were supported to participate in a range of appropriate activities and to pursue their hobbies and interests. Activities were tailored to the individual and staff who shared the same interests supported them.

People told us they were confident to raise any issue of concern with the registered provider and staff and that it would be taken seriously. They had weekly house meetings to discuss any matter that affected them. They also had contact details for other agencies they could approach to help them raise complaints.

People had also been encouraged to express their views and opinions of the service through regular house meetings, care reviews, staff appraisals and during day to day discussions with staff and management. There were opportunities for people to give formal feedback about the service, the staff and their environment in quality assurance surveys. Recent surveys showed overall ‘excellent’ satisfaction with the service provided.

People said the management of the service was excellent. Staff and people using the service told us they had confidence in the registered provider and considered they were ‘listened to’. There were systems in place to monitor the quality of the service and evidence the findings supported business planning and development.

People using the service were given copies of policies and procedures that affected them. These helped them know how staff will respect and support them to make sure their rights to dignity, choice, independence, fulfilment and privacy was being promoted.

There were excellent internal and external quality monitoring systems in place to monitor the quality of the service. This meant there was constant oversight of the service and this provided an opportunity for everyone to reflect and improve the service where needed. There was evidence these systems had identified areas for improvements and these had been made. The registered provider regularly visited each of the houses. This helped her to keep in touch with people using the service, monitor staff practice, review the quality of information in people’s records and to obtain people’s feedback about the service provided.

People did not express any concerns about the management and leadership arrangements. They said, “We see (registered provider) a lot. She is always checking to see if everything is all right. Any problems we have we just ring the office for help and advice.” Staff reported having ‘job satisfaction’ and one staff member said, “We all work well together making sure people get a very good service. I’m very happy working here.”

We found people spoken with were happy with the care and support they received. One person told us, "I am very pleased, staff always help me and we always have fun' another person commented, "We are really well supported and we are happy here and have no complaints'.

Staff were provided with appropriate training opportunities and received regular supervision and appraisal. One carer told us the service was really good and they felt supported by the management team. They said, 'It is a pleasure to come to work' and they were provided with updated training and supervision.

Suitable arrangements were in place to ensure people receiving a service were safeguarded against the risks of abuse.

There were systems in place to monitor and assess the quality of the service. People were asked their opinion of the service and were given the opportunity to complete customer satisfaction questionnaires. We saw the results of the questionnaires completed in October 2012 and noted people had a high level of satisfaction with the service.

One relatives comments we looked at told us that they were 'Totally satisfied with the level of care given to my mum' as well as stating that the service was exceptional and the carers couldn't do enough. Other comments included, 'Would recommend Parkhouses to anybody as they accommodate anybody and anything at the drop of a hat 100/100'.

Suitable arrangements had been made to obtain consent and involve individuals and family members when arranging the care package.

We saw that people using the service had detailed support plans in place and an assessment had been carried out before the service started. People had their care package reviewed on a regular basis to ensure the care they were receiving was suitable and appropriate.

Suitable policies and procedures were in place to ensure that any complaints about the service were acted upon in a timely manner and contact numbers had been provided to people using the service should they need to contact someone in an emergency.

Staff had received training to assist people with their medication and policies were in place. Appropriate records had been maintained when staff had handled any individual's medication (creams).

Staff had been effectively recruited with checks in place and appropriate records maintained.