21 & 22 January 2016
During an inspection looking at part of the service
This unannounced inspection took place on 21and 22 January 2016. Parklands Court is registered to provide accommodation, nursing and personal care for up to163 people. It is split into six different units. Harrison and Collins can accommodate up to 30 people. Marlborough can accommodate up to 24 and Elmore which is a unit off Marlborough can accommodate up to 16 people. Clarendon can accommodate up to 33 and Samuel up to 28 people. All the units have their own separate living and dining areas.
There was a registered manager in place however they were leaving the company and had deregistered as manager with effect from 6 February 2016. A new manager had been recruited and was present on the day of the inspection. 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.
People, their relatives and staff raised concerns about staffing levels on five of the six units. We saw people did not always receive support when they needed it and had to wait for staff to be available to provide support. People did not always receive their medicine in a timely way. Systems were not in place to ensure people received their medicine safely.
People were supported by staff who knew how to keep them safe. When people had identified risks to their health and safety staff knew how to support them and risk assessments were in place for staff to follow. A system was in place to ensure staff were recruited safely.
Staff understood the principles of the Mental Capacity Act. Where people lacked the capacity to provide consent or make decisions about their care, the principles of the Mental Capacity Act 2005 were followed in some of the units. However improvements needed to be made in assessing people’s capacity when they lacked capacity to consent to their medicine in Clarendon Unit.
People told us they did not always have the choices with regards to their food. People, their relatives and staff told us staff the correct training to meet people’s needs. People had access to healthcare professionals when their health needs changed.
Some people told us they did not always get the care they wanted. People were left for long periods of time with no interaction from staff. We saw people’s privacy and dignity was not always respected by staff. People had choices with regards to their care and staff respected their choices.
People were encouraged to maintain relationships that were important to them.
People did not always have access to leisure opportunities. People were supported by staff who knew their individual preferences. Care records usually reflected people’s care needs. However improvements were needed in some areas to ensure all people involved in their care were aware of people’s up to date care needs.
People and their relatives told us they were comfortable in raising complaints. We saw a system was in place which showed when people complained they were listened to.
There was a management structure in place which meant people received different experiences of care in each of the units. People and their relatives were not always aware of the management structure.
People had opportunities to comment on the care they received. However where issues were highlighted remedial action had not always been taken. A quality assurance system was in place but it was not always effective as it had not highlighted the concerns raised in our inspection. For example the medicine errors we highlighted to the registered manager. Staff felt supported in their role.