Archived: Parr Mount Court

Parr Mount is an extra care service that is registered to provide personal care to people in their own homes. Extra care is where live in their own flat, however have the option of receiving care should they need it. At the time of the inspection the service was providing support to 33 people.

A manager was in post who had been registered with the CQC since October 2013. 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.

Systems were not always effective in identifying where areas of improvement were required. For example there was no formal process in place for monitoring accidents and incidents and we found that staff training was not always up-to-date. Systems had also failed to identify where risk assessments had not been completed in people's care records. You can see what action we told the provider to take at the back of the full version of the report.

Personalised risk assessments were not always completed around people’s individual needs. For example risk assessments for two people at risk of developing pressure sores had not been completed. In another example, a risk assessment had not been completed around the risks associated with one person’s diabetes. We followed up on these issues to ensure these people were safe, and found that they were. We have made a recommendation around completing risk assessments in relation to people’s needs.

Training had not always been updated to ensure that staff knowledge was up-to-date. People did not raise any concerns about the competencies of staff, and we did not observe any examples of poor practice. The registered manager had a plan in place to ensure that staff training would be brought up-to-date.

There were robust recruitment processes in place which ensured that staff were of suitable character to work with vulnerable people. New staff had been through appropriate checks, and had been through an interview process which had helped the registered manager determine their suitability for the role.

There were sufficient numbers of staff in place to meet people’s needs. The registered provider was changing the staffing rotas to increase the number of staff on shift, in response to a consultation with staff. This ensured that people’s safety was maintained, and also showed that the registered manager had involved staff in making improvements to the service.

People had been supported to take their medication as prescribed. Medication administration records (MARs) showed that staff had given these as prescribed. These were stored in people’s own homes, and care records outlined where staff were required to administer these, or where people took their own medicines.

Care records contained information around people’s life history, and preferred daily routines. This helped staff to get to know people. People told us that positive relationships had developed between themselves and staff, and that staff treated them with respect. People also confirmed that staff maintained their dignity and privacy.

Care records outlined where people required support with meal and drink preparation. People confirmed that staff provided them with the support they required with regards to this. We also observed that staff left people with juice or water to ensure that they did not become dehydrated. This protected people from the risk of poor nutritional intake.

People were supported to access support from health professionals where they required help to do so. This helped ensure people’s health and wellbeing was maintained.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

This is a summary of what we found.

Parr Mount Court (Making Space) is an Extra Care service. The agency was providing support and care to people living in their own tenancies (flats).

Is the service safe?

We saw that people had been cared for in their own homes and the service had checked if this was safe, clean and hygienic. Equipment in people's homes to assist staff was assessed by the service as suitable to meet people's needs. We were told by people using the service that the staff arrived on time and stayed for the correct amount of time. They told us that staff were, 'All very good', 'We couldn't have better staff than we have now' and 'You couldn't wish for better care. Don't know what I would do without them'. We saw records which demonstrated that there were sufficient staff available to meet people's needs.

The staff recruitment records did not initially contain all the information required by the Health and Social Care Act 2008. The manager was able to access the information from the head office of Making Space. It was acknowledged by the manager that recruitment records would all be audited and reviewed to reflect that relevant recruitment checks had been carried out. This would help ensure a safe and robust recruitment process was in place.

Is the service effective?

We visited four people in their own flats who told us they were happy with the care that had been provided. We also spoke with five other people who lived at the service. Some of their comments were, 'Its five stars, its fantastic', 'Never had to complain. I am always treated respectfully' and 'I know who my keyworker is. The staff are so loyal'. We spoke with seven members of staff and they all were able to demonstrate that they had a clear understanding of people's needs and how to meet them.

Staff training was consistent, with appropriate and relevant training being provided. We saw that supervision of staff was regularly provided. This meant the provider could demonstrate that the staff employed to work for the service had the training and support to meet people's needs

Is the service caring?

During our inspection we observed that staff were attentive, caring and enthusiastic about supporting the needs of people who received a service.

People we spoke with told us that, 'The staff were all fine', 'Good team of girls' and 'All of the staff are really good".

Is the service responsive?

People's needs had been assessed before they received a service. We heard the manager discussing with hospital staff how the service needed to re- assess a persons changed needs before they could agree to provide a service.

Peoples care records (care plans) were not always consistent, as an example the medication administration process for individuals was not always clearly recorded. The care plans did not have any background or social history for people using the service. The manager confirmed that they have developed new care plans, which included a social / background history section and the administration of medication guidance would be more robust.

Is the service well-led?

No regular quality monitoring survey forms had been given to people using the service. We observed a new survey form, which had recently been developed. The manager informed us that the surveys will be sent to people using the service before the end of June 2014. This means that the provider would be able to ascertain people's opinions and views, which could positively change the service delivery.

Some of the comments from people using the service were, 'Never had to complain, I would if I needed too' and 'This is the best place I have lived, the care is really wonderful'.

A member of staff we spoke with described working at Parr Mount Court as "really enjoyable." We asked about the support they received with training, and how well prepared they were to work with people with such varying needs. They told us that the training and induction they had received was "the best I've ever had." They explained how they had not previously considered working with adults in supported living environments, but said that they were glad they had made the decision to do so, telling us, "It's really rewarding and actually a very happy environment for the people living here."

We spoke with the acting manager and Operations Director about some problems experienced in the past 12 months, in particular the need for a permanent Registered Manager for this service. We understand that this appointment has now been made and the person will take up post in May 2013.