Parklands Care Centre
Newport Road, Bedwas, Nr. Caerphilly, NP10 8BJ
No of beds: 38 Care Home with Nursing
Category: 29 Older Person (Nursing) / 9 Older Person (Residential – please make enquiries with home as phasing out residential care)
Dual Registered
Tel: 029 2088 0525
Email: parklands.manager@hc-one.co.uk
Website: www.hc-one.co.uk
Contract Monitoring Report
- Name/Address of Provider: Parklands Care Centre, Newport Road, Bedwas
- Date of Visit: 4th May 2023
- Visiting Officers: Caroline Roberts, Contract Monitoring Officer (CMO) / Jay Ventura-Santana, Lead Nurse for Care Home Governance and Safeguarding, Aneurin Bevan Health University Board (ABHuB)
- Present: Alison Durbidge, Home Manager / Amy Campbell, Deputy Home Manager
Background
Parklands is a purpose-built home in Bedwas, Caerphilly, which provides nursing and residential care for up to 38 people.
The last formal monitoring process was undertaken in 2018 after Parklands had been through a period of close monitoring by both Aneurin Bevan University Health Board and Caerphilly County Borough Council due to ongoing concerns. At the time of the visit in 2018, this process had concluded as improvements had been made.
Due to the Covid 19 pandemic, visits to the home were suspended in order to safeguard the residents and staff and to minimise footfall. However, telephone and email contact was maintained throughout.
Visits throughout 2022 were undertaken by the Local Health Board and the CMO on a catch-up basis and informal monitoring after the Covid pandemic.
Visiting officers employ a variety of monitoring systems to gather and interpret dataas part of monitoring visits, including observations of practice at the home, examination of documentation and conversations with staff, service users and relatives where possible.
The last CIW inspection was undertaken in January 2022 and is located on their website for public viewing.
Dependent on the findings within the report, corrective and developmental actions will be given to the provider to complete. Corrective actions are those that must be completed (as governed by legislation); developmental actions are good practice recommendations.
Findings
Registered Manager
The Home Manager is registered with Social Care Wales and the Deputy Manager is a registered nurse. The Home Manager manages one home; however, the Manager has previously been requested to assist sister homes when required.
The Home Manager was asked a series of questions as part of the monitoring process and advised the CMO that the home does not have CCTV. At the time of the visit, the home had 5 residential placements, with the remaining residents requiring nursing support.
At the time of the visit, there were no concerns with the maintenance of the home and all equipment was in working order.
Residents at Parklands may alter the temperature of their room by individual controlled radiators.
The Manager advised that they are supported by their Responsible Individual, and they last visited on 1st March 2023, with a visit pending in order that they complete their Regulation 80 report.
If the Registered Manager is absent, the Deputy Home Manager will oversee the running of the home; however, should the Home Manager be absent for a pro-longed period, HC One would request the 2 Relief Managers (in Wales) to assist, along with Managers from neighbouring HC One homes.
In the absence of the Responsible Individual, HC One have a number of colleagues who would support in this role, including the Quality Support Team.
Registered Individual
The Registered Individual has the overall responsibility of the running of the home, and it is expected that they visit the home and complete a Regulation 73 visit/report on a quarterly basis.
The visit will cover various aspects of the running of the home i.e. the welcome you receive, property issues/concerns, recruitment, staff feedback, resident/representative feedback, cleanliness of home, kitchen area, response times to call bells, resident file audits, key clinical indicators, medication audits etc.
The report outlines the findings and actions that need to be taken in order to meet standards and expectations as outlined within the Statement of Purpose.
The home’s Statement of Purpose explains to the reader what their can expect from the home and it was last reviewed October 2022. The document outlines how the service is provided, how many individuals it can support (38), the standards HC One strive for, staffing levels, advocacy etc.
During discussion with the Home Manager, they advised that they feel supported by their Responsible Individual and, also the Area Director.
Staffing, Training and Supervision
At the time of the visit, there was a nurse vacancy equating to 33 hours (nights).
The home is supported by 2 nurses during the day and 4 care staff, 1 Nursing Assistant and 1 Senior. During the night, the support is provided by 1 nurse, 2 carers and 1 Senior.
The home has 2 activity co-ordinators, which support residents with crafts, outings, entertainment, reading, hand massages etc. However, all staff have a responsibility to offer stimuli to the residents residing at the home.
Agency nurses are sometimes used, and the Home Manager and Deputy ensure that they use the same agencies to offer consistency to the residents.
E-learning (Touchstone facility) is used for training purposes, along with classroom-based training.
Mandatory training was observed to be up-to-date and any outstanding/overdue training is highlighted for the Manager appropriate attention. At the time of the visit Basic Life Support (1st Aide) was 92.3% compliant, Food safety, 86.7%, Health & Safety 100%, Infection Control 88.9%, Safeguarding 80% and Moving and Handling 93.3%. Non mandatory training is also undertaken in order to support the staff to provide appropriate care and support i.e. Falls Awareness, Choking, Nutrition and Hydration, Dementia Care, Promoting Healthy Skin, Deprivation of Liberty Safeguards to name but a few.
One to One supervision’s are held and from the matrix viewed, all staff last attended a supervision in February, March or April; dates for a 3 monthly supervision are then populated on the matrix for a follow up supervision. It is the managers responsibility to ensure all staff have a quarterly supervision.
At the time of the visit, no member of staff was working over 48 hours per week.
On arrival at the home, each new resident is asked about their First Language of choice and the home will do its utmost to accommodate this as in line with HC One’s Statement of Purpose.
Two staff files were observed and both files held two written references. One file was of a nurse who is employed at the home via sponsorship. Both files held a job description, a detailed application form and an interview record. Neither application form highlighted any gaps in employment. Only one file held a copy of the individual’s birth certificate, the Home’s Administrator explained that the 2nd staff member was in the process of applying for a copy.
Both files held a copy of the individuals’ passport, a photograph was present and training certificates were viewed. The nurses NMC Registered Nurse (Adult) was viewed as being dated April 2023. Home Office checks had been undertaken and a Police Certificate (International) was observed on file. The 2nd file held an up-to-date DBS dated April 2023.
A certificate of sponsorship UK visa and immigration was also observed.
Resident Documentation
For the purpose of the monitoring visit, two residents’ files were examined. Pre-admission assessments, which determines whether or not the home is in a position to meet the needs of the individual, were observed on both files.
Personal Plans were evident and were found to be person centred in respect of the care that is required; however, more detail to personal outcomes/goals need to be included.
When reviewing the personal plans, the home must demonstrate what information has been utilised to feed into the plan’s development i.e. the individual/representative has provided information, the social worker has been contacted for information and the viewing of the daily records to note any changes in mood, presentation, diet, fluid intake etc.
Appropriate Risk Assessments were observed to be in place i.e. Eating/Drinking, Choking, Falls, Dietary Treatment Plan, Moving and Handling etc. Reviews were observed to be undertaken on a monthly basis.
The files viewed, evidenced that staff are aware of how to refer an individual to appropriate outside agencies i.e. GP, Dentist, Dietician, chiropodist.
For those on weekly weights, information is being documented and appropriate professionals are contacted should an individual be seen to be consistently losing weight i.e. GP, Dietician.
Kitchen staff receive up-to-date diet notifications, which are signed by both the member of staff undertaking the review and the chef. This evidences that both parties are knowledgeable of the type of diet an individual requires and the risks associated should the incorrect consistency be provided. i.e. puréed, fork mashable etc.
Whilst being a sensitive topic, it was evident that conversations had taken place either with an individual or family, in respect of a DNACPR (Do Not Attempt Cardio-Pulmonary Resuscitation). This gives an individual a choice and an opportunity to share their wishes and views for their end-of-life plan.
At the time of the visit, the Manager advised the visiting officer that the home was up-to-date with its DoL’s (Deprivation of Liberty Safeguards).
Both files held a brief life history of the individuals; therefore, providing the reader with background of the individual i.e. childhood, marriage, employment, children, pets, hobbies etc.
Both files held Personal Emergency Evacuation Plans (PEEPs); however, whilst one was dated February 2023, the 2nd document was dated 2019. Therefore, this document requires reviewing and up-dating.
Diet notification forms were observed on both files, and both had been signed by the Home Manager and the Home’s chef. These are reviewed annually or as and when a change occurs.
Resident & Representative Feedback
The visiting officers spoke with a number of residents during the visit. The visiting CMO met with one gentleman and his visitors. The gentleman was an ex-serviceman and his friends (former comrades) advised that they visit every week, and all parties were eager to share some of their past experiences.
The individual’s room was decorated with all of his medals and photo’s of his comrades in areas where they had undertaken active service.
The induvial was new to the home and the friends who represent the individual had no concerns about the care or the support provided. They requested a fan for the room and a senior provided one instantly.
The individual was observed to be in good spirits and well kempt.
The representative made enquiries about a dentist visiting and this was brought to the Home Managers attention for an appropriate referral to be made.
All parties advised that the food at the home was good and that they had no concerns to raise.
Fire Safety/Health & Safety/ Home Maintenance
The last fire assessment was completed in April 2023 and at the time of the visit, the report was not available as it had not been shared with the Home. However, the Maintenance Operative advised that there were no recommendations and that it was a very thorough inspection.
The fire drill records were observed, and these are undertaken by the Maintenance Operative.
A grab bag was also observed in the main foyer should an emergency occur.
Regular maintenance checks throughout the home are undertaken by the Maintenance Operative
The administrative officer has responsibility for managing the resident’s money. Money that is received is electronically recorded and formal paper receipts are used. One copy is retained by the resident/family member; one is retained in the recording book whilst the third is retained by the office. Residents have individual accounts and any money paid in/taken out is signed for by two officers (the administrative officer and the home Manager).
During the visit, it was observed that residents freely approach the maintenance officer to request that he resolves SKY issues, replace batteries of hearing aids, place photo frames on the walls of bedrooms etc.
All accidents are datixed and over the last 6 months there have been no trends or patterns observed.
Facilities
The home is decorated in light décor and inviting to visitors. The Manager’s and Administrator’s office is located to the left of the entrance and to the right is an open and welcoming coffee area where some residents like to meet their visitors.
There is a large, open planned conservatory, dining room and lounge area. The lounge has doors that open into the garden area, which is home to a pergola, allowing the residents to sit outdoors, undercover should the weather permit.
The home has its own minibus and regular trips are taken to Barry, Roath Park, Garden Centres, Ikea, restaurants and local pubs throughout the year. At the time of the visit, residents were observed to be taking part in an exercise activity from an external provider. The home also engages with ‘Burns Gym’ which provides exercise and mental stimuli for those residents wishing to participate. For individuals cared for in bed, the activity co-ordinators/care staff will read, paint nails, provide hand massages etc.
Quality Assurance
The home has a HC One internal complaints procedure; however, the Manager advised that they operate an open-door policy and would rather any issues or concerns be addressed with them in the first instance; therefore, allowing the home to resolve matters immediately. Formal complaints are recorded on an electronic system and are closed when resolved. All formal complaints are to be formally resolved within 4 weeks. Should a complaint involve members of staff, feedback is provided, by the Manager on a 1:1 basis and appropriate measures/actions taken if required.
Compliments via cards are displayed on the notice board for all to see and the Home Manager is encouraged to share positive feedback with the monitoring officer when received.
Regular staff meetings are held, and the minutes are signed by the staff in attendance. The main focus of the meetings varies, depending on what matters become a priority i.e. lessons learned from any concerns raised or via audits, medication, agency staff issues etc. The minutes of the meeting are added to an electronic package ‘Deputy’ which all staff are assigned to and can access at any time.
Resident/Representative meetings recommenced in April 2023 and during the meeting, residents advised the Home Manager and the Deputy that they would like more, regular entertainment. They discussed outings, Church services, fancy dress parties, movie afternoons, bingo; therefore, there were a lot of ideas from the residents that the Activity Co-ordinators can consider.
Parklands Care Home does not currently have a Dementia Champion.
The Nurse and Senior Care Assistant will undertake a verbal handover prior to commencing a shift. Handover will contain information regarding any change in medication, any areas of concern, change in behaviour/mood etc. Such information is documented, and each floor has its own handover folder, that staff may refer to anytime during their shift.
Environmental
The home is decorated to a high standard and is clean and tidy throughout, with no malodours and no hazards being observed during the visit.
All staff and resident files were observed to be stored securely.
The doors to individual bedrooms have a photograph of the resident and their name. The bedrooms consist of a bed, wardrobe and a small cabinet with a T.V. Residents decorate their rooms with personal belongings, family photographs, sentimental items, decorative bedding etc.
There is a small coffee area upstairs, with facilities readily available, which again is accessible for all to use.
Corrective and Developmental Actions
Corrective
Personal Plans were evident and were found to be person centred in respect of the care that is required; however, more detail to personal outcomes/goals need to be included. RISCA Reg. 6
When reviewing the personal plans, the home must demonstrate what information has been utilised to feed into the plan’s development i.e. the individual/representative has provided information, the social worker has been contacted for information and the viewing of the daily notes to note any changes in mood, presentation, diet, fluid intake etc. RISCA Reg. 16
Developmental actions
Personal Emergency Evacuation Plans (PEEPs) to be reviewed annually, or sooner should an individual’s circumstances change.
For the Manager/Deputy Manager to share with the Local Authority any compliments received.
Conclusion
The home has a stable management team in place and it was evident that the Home Manager, Deputy Manager and the Home Administrator have a positive working relationship which enhances the staff team.
During the course of the visit, staff were observed to interact well with the residents, sharing smiles and laughter and singing with each other. Residents were observed to be treated with dignity and respect.
Routine monitoring will continue at Parklands Care Centre and the Monitoring Officer would like to thank all involved for the hospitality shown during the visits.
- Author: Caroline Roberts
- Designation: Contract Monitoring Officer
- Date: 22/05/2023