The Parklands Care Home

The Parklands Care Home is a residential care home providing personal care for up to 40 people. At the time of our inspection there were 27 people using the service. Some people using the service were living with dementia.

People’s experience of using this service and what we found

Since our last inspection we found the provider had employed a regional manager to guide and support the management team. Systems and processes to monitor and improve the home had been reviewed to ensure improvements were recognised and actioned on. These systems required embedding in to practice to ensure their efficacy.

Risks associated with people’s care had been identified and actions taken to mitigate risks. People received their medicines as prescribed, by staff who were trained and competent to administer medicines safely. Accidents and incidents were analysed to ensure future incidents were reduced. Staff had been recruited safely. There were enough staff available to meet people’s needs in a timely way.

Routine maintenance checks had been carried out to ensure the building was compliant with health and safety requirements. We carried out a tour of the home and found improvements in regard to infection control and prevention. We also noted some improvements to the decoration of the home which had visibly improved the home.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 13 October 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Parklands Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The Parklands Care Home is a residential care home providing personal care for up to 40 people. At the time of our inspection there were 27 people using the service. Some people using the service were living with dementia.

People’s experience of using this service and what we found

The provider had a system in place to monitor the quality of the service, however, this was not always effective. There was a lack of leadership and governance and this impacted on the service provided to people. There was little information to show people and their families had been communicated with and kept informed about the service and their family members.

Risks associated with people’s care were identified but not always managed safely. We found care plans lacked important information to assist staff in providing safe care. We carried out a tour of the home and found some concerns regarding infection prevention and control. Some areas of the home needed a deep clean and some areas were poorly maintained. There was little evidence to show lessons had been learned when things went wrong. People mainly received their medicines as prescribed. However, we informed the registered manager of some minor issues and they took appropriate actions.

People were safeguarded from the risk of abuse. There were sufficient staff available to meet people’s needs. Staff were recruited safely and had pre-employment checks to determine their suitability for employment.

People were supported to have maximum choice and control of their lives and staff support people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 22 June 2018).

Why we inspected

The inspection was prompted in part due to concerns received about infection control, care planning, governance and risks. A decision was made for us to inspect and examine those risks. We looked at the key questions of safe and well led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Parklands Care Home on our website at www.cqc.org.uk

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

The provider had a process in place to enable relatives to visit their family members in a safe way and in line with government guidance. Relatives were required to show a negative lateral flow test prior to entering the home.

Professional visitors were required to show a negative lateral flow test and evidence of COVID-19 vaccination. Visitors had their temperature taken in the entrance area and completed a form to ensure they are not showing any symptoms of illness.

Staff and people using the service took part in the home’s testing programme. This enabled the provider to take swift action if they tested positive with COVID-19.

Social distancing was observed as far as it was practicable to do so.

We observed staff wearing appropriate PPE and had access to hand sanitiser. Staff had completed training in infection control, COVID-19 and donning and doffing PPE.

The home was clean and there were no malodours. Staff had access to cleaning products and cleaning schedules were in place. The registered manager completed infection control audits to ensure the home remained clean and well maintained.

We found the following examples of good practice.

The provider was facilitating safe visiting. The way visiting took place had been well thought out and the available space was well utilised to ensure it was safe for visitors to enter and exit the building.

There was ample supplies of PPE available throughout the home. We saw donning and doffing stations provided in frequently used areas.

The service had a number of visible signs in predominant areas so people were able to see what was expected in terms of infection control practices.

The service was accessing the government testing scheme which assisted them to identify and respond quickly to the possibility of an outbreak.

We found the following examples of good practice.

The service was accessing the government testing scheme which assisted them to identify an outbreak quickly. The service worked with the local authority infection, prevention and control (IPC) team and other health professionals in managing the outbreak.

There were clear infection prevention signage at the point of entry and throughout the home and clear communication with staff reinforced hygiene practices.

Staff told us they had a plentiful supply of personal protective equipment (PPE), such as disposable masks, gloves and aprons. There were PPE stations and hand sanitising points throughout the home.

People isolating in their rooms had regular contact with staff who wore personal protective equipment (PPE) appropriately. Staff also helped people to maintain links with their family and friends.

Further information is in the detailed findings below.

The Parklands is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The Parklands provides accommodation for up to 40 older people, some who are living with dementia. The home is situated in the Thorne area of Doncaster. At the time of the inspection 22 people were living at the home.

At the last inspection in November and December 2016 the service was rated Requires Improvement. This was because we identified shortfalls in staffing, staff supervision, meals and maintenance. These issues had not been identified by the registered provider through the monitoring system in place at that time, or where they had, action had not been taken to address them in a timely manner. This was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following the last inspection we asked the registered provider to complete an action plan to show what they would do and by when, to improve the key questions Safe, Effective and Well Led to at least good. At this inspection we found a marked improvement in most of these areas. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

The service did not have a registered manager in post at the time of our 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. The registered provider had appointed a new manager and they told us they were applying to be registered with the Care Quality Commission.

At this inspection people who used the service and the visitors we spoke with told us they were happy with how care and support was provided at the home. They spoke positively about the staff and the way the home was managed. People told us they felt safe living in the home. We saw there were systems in place to protect people from the risk of harm.

Staff we spoke with were knowledgeable about safeguarding people and were able to explain the procedures to follow should an allegation of abuse be made. Assessments identified any potential risks to people and care plans were in place to help ensure people’s safety.

Medicines were stored appropriately and the audit procedures had been improved. There was enough skilled and experienced staff on duty to meet people’s needs.

There was a safe recruitment process and new staff received an induction into how the home operated and their job role, at the beginning of their employment.

Staff had access to training that met the needs of the people using the service. However, some staff needed more support to complete the e-learning programme that was available.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People were provided with a choice of healthy food and drink ensuring their nutritional needs were met. People said they were happy with the meals.

People’s needs had been assessed before they moved into the home and they and their relatives were involved in planning their care. The care files we checked reflected people’s needs and preferences, so staff had clear guidance on how staff should provide care to them.

People had access to a programme of activities and entertainment, as well as trips out into the community.

People said they would feel comfortable speaking to staff if they had any concerns. There had been improvements made to the system for monitoring and improving the quality of the service provided.

Further information is in the detailed findings below

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘The Parklands Care Home’ on our website at ‘www.cqc.org.uk’.

The Parklands Care Home provides accommodation for up to 40 older people, some who are living with dementia. The home has two distinct areas, the main area of the home and a smaller area where people had a higher level of need and were living with dementia. The smaller area is referred to as unit 2 by the staff and visitors to the home. The home is situated in the Thorne area of Doncaster. At the time of the inspection 27 people were using the service.

The service did not have a registered manager in post at the time of our 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. The previous registered manager had recently left the service and the registered provider had recruited a new manager. A team leader was running the home on a day to day basis until the new manager came into post.

Although staff worked well as a team, most told us they were not always able to respond to people’s needs, because there were not always enough staff around to enable them to do so. People’s relatives also expressed concern about the numbers of staff available.

We saw that medicines were not always managed in a safe manner.

Not all risks associated with people’s care had been identified and action had not always been taken to reduce these risks.

For the most part, people were supported to make decisions about their care and their choices were respected. Care plans included information about people’s likes and dislikes.

Staff received support and supervision to help them meet people’s needs. Staff completed training and received periodic refresher sessions, although there was a need to provide training to staff in caring for people at the end of their life and some staff needed further training in the Mental Capacity Act (MCA).

People were supported to maintain good health and received on-going healthcare support. Overall, people received a nutritious and balanced diet. Snacks and drinks were offered throughout the day.

We observed staff interacting with people who used the service and found they were respectful and caring and very committed to people’s welfare. People we spoke with liked the staff and got on well with them.

A good range of social activities were provided in the home and there was an activity co-ordinator who had built particularly positive relationships with people.

There was a complaints procedure and people we spoke with told us they would talk to the manager or staff if they had a complaint.

People who used the service were involved in the development of the home and were able to contribute ideas. We saw audits took place to ensure policies and procedures were being followed, although the registered provider had not always responded in a timely way when repairs were identified as needed.

We found three breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in respect of governance, staffing and the management of medication. You can see what action we told the registered provider to take at the end of this report.

The Parklands provides accommodation for up to 40 older people, some who are living with dementia. The home is situated in the Thorne area of Doncaster.

The service did not have a registered manager in post at the time of our 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. The registered provider had appointed a manager and the manager had told us they were applying to be registered with the Care Quality Commission. However, at this inspection they told us that they were leaving their post and no longer pursuing their registration. This meant that the home had been without a registered manager for a significant period of time.

Although staff worked well as a team, most told us they were not always able to respond to people’s needs, because there were not always enough staff around to enable them to do so.

The manager had a plan in place to make sure that all staff were up to date with all aspects of their training. However, they had not been able to provide all staff with formal, one to one supervision as regularly as they should. Additionally, the manager themselves had not received professional supervision in all the time that they had been in post.

We saw that quality and safety audits took place, but they were not always effective and the registered provider had not always responded in a timely way when improvements were identified as needed.

There was a policy to protect people from abuse. Staff had received training in this area and knew how to recognise and respond to abuse.

We saw that people received their medicines in a safe manner.

Risks associated with people’s care had been identified and action had been taken to reduce the risk from occurring.

People were supported to make decisions about their care and their choice was respected. Care plans included information about people’s likes and dislikes.

Overall, people received a nutritious and balanced diet. Snacks and drinks were offered throughout the day.

People were supported to maintain good health, have access to healthcare services and received on going healthcare support.

We observed staff interacting with people who used the service and found they were calm, respectful and caring. People we spoke with liked the staff and got on well with them.

A good range of social activities were provided in the home and there was an activity co-ordinator. We saw lots of events had been organised.

There was a complaints procedure and people we spoke with told us they would talk to the manager or staff if they had a complaint.

People who used the service were involved in the development of the home and were able to contribute ideas.

We identified a breach of the Regulations in relation to governance. You can see what action we told the provider to take at the end of this report.

The Parklands provides accommodation for up to 40 older people, some who are living with dementia. The home is situated in the Thorne area of Doncaster.

The service did not have a registered manager in post at the time of our 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. The provider had appointed a manager and they were in the early stages of applying to be registered with the Care Quality Commission.

The provider had a policy to protect people from abuse. Staff had received training in this area and were knowledgeable about how to recognise and respond to abuse.

We saw that people received their medicines in a safe manner. We looked at records in relation to medicine management and found each person had a medication administration record (MAR) in place. This clearly evidenced when people had been given their medicines.

Risks associated with people’s care had been identified and action had been taken to reduce the risk from occurring.

We saw that there was enough staff around to ensure people’s needs were met. Staff worked well as a team and were able to respond to people’s needs. The provider had a staffing tool which was used to determine the correct number of staff to be on each shift.

We looked at records in relation to training and spoke with the manager. The manager told us they had found it difficult to ascertain what training staff had completed prior to her working at the home. The manager showed us a plan she had put in place to ensure that all staff were up to date with all aspects of training.

People were supported to make decisions about their care and their choice was respected. Care plans included information about people’s likes and dislikes.

People received a nutritious and balanced diet. Snacks and drinks were offered throughout the day. We spoke with the cook who was knowledgeable about the different dietary requirements people had, and provided meals to suit their needs and tastes.

People were supported to maintain good health, have access to healthcare services and received ongoing healthcare support.

We observed staff interacting with people who used the service and found they were calm, respectful and caring. People we spoke with liked the staff and found they got on well with them.

The manager was in the process of working with people and staff in updating people’s care plans and introducing new documentation. We looked at three care plans and found that in the main people’s needs were identified, reviewed and carried out.

Social activities were provided in the home and the provider employed an activity co-ordinator. We saw lots of events had been organised.

The provider had a complaints procedure and people we spoke with told us they would talk to the manager or staff if they had a complaint. We did not see any information displayed which would inform people how to complain or what the process was.

During our inspection we saw the registered manager interacted well with staff and people who used the service.

We saw audits took place to ensure policies and procedures were being followed, although these were in the early stages and required embedding in to practice.

People who used the service were involved in the development of the home and were able to contribute ideas.