Archived: Parkfield House Care Home

Parkfield House in Thwaites Brow, Keighley provides nursing care for up to 24 people aged over 65 years. It is a converted house which has 17 bedrooms comprising of eight doubles and nine singles. There are two lounges on the ground floor and one lounge upstairs. The home has a large conservatory overlooking tiered gardens and a patio area. There is a passenger lift for access to the upper level as well as stairs. All food is prepared on the premises and there is a laundry.

At the time of our inspection the service was without a registered manager. The previous manager left in April 2017. In the interim a manager from the provider’s other home is overseeing the service until a new manager can be appointed. 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 told us they felt the service was safe. Staff had a good understanding of safeguarding and knew how to report any concerns about people's safety and welfare. We found safeguarding concerns were being referred to the local safeguarding team and the Commission.

The provider followed a robust recruitment procedure to ensure new staff were suitable to work with vulnerable people. Staff training had improved and the majority of staff were up to date with training on safe working practices. However we found staff supervision was not regular or consistent and appraisals had not been completed this year.

Overall we found people's medicines were managed safely. Although records did not always show when creams and lotions known as ‘topical medicines’ were applied and how often; we were told this issue would be addressed by the interim manager during the inspection.

We found staff were not working in accordance with the Mental Capacity Act which meant people's rights were not always protected.

We found people’s health care needs were met and relevant referrals to health professionals were made when needed.

Although staff generally responded to people’s individual needs; this was not always reflected in people’s care records. People’s care plans and other records required improvement.

People had their nutritional needs met and were offered a choice at every meal time. People were offered a varied diet and were provided with sufficient drinks and snacks throughout the day. People with specific nutritional needs received support in line with their care plan.

A range of activities was offered for people to participate in and people told us they enjoyed these.

There were systems in place to ensure complaints and concerns were fully investigated. The provider had dealt appropriately with all complaints received.

We found some areas of the home would benefit from refurbishment. Equipment were appropriately maintained and we noted safety checks were carried out regularly.

People, relatives and staff spoken with had confidence in the service. We found there were systems to assess and monitor the quality of the service, which included feedback from people living in the home and their relatives.

Although there were quality monitoring systems in place they had not been effective in achieving the required improvements in the service. This showed us that further improvements were still required to the governance systems in place at the home.

In addition to an on-going breach of regulation in relation to good governance (Regulation 17) we found two new breaches of regulations in relation to safe care and treatment (Regulation 12) and safeguarding service users from abuse and improper treatment (Regulation 13).

You can see the action we have asked the provider to take at the back of the full version of this report.

(Regulated Activities) Regulations 2014. Following the inspection we took enforcement action. The commissioners at the Local Authority and Clinical Commissioning Group (CCG) were made aware of our concerns and placements at the home were suspended. Following the inspection the provider sent us an action plan which showed how the breaches would be addressed. This inspection was to check improvements had been made and to review the ratings.

Parkfield House Care Home provides nursing and personal care for up to 24 older people, some of who are living with dementia. There were 19 people using the service when we visited in Aril 2016. Accommodation is provided over two floors. There are nine single rooms and eight shared rooms. There is a large conservatory and lounge areas on the ground floor and a small sitting area on the first floor.

The home does not have a registered manager. The registered manager left in 2014 and the current manager is not registered with the commission. 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.

Overall we found significant improvements had been made in the home since our last inspection, although there were still areas where further improvement was required.

People told us they felt safe and we found there were enough staff on duty to meet people’s needs. Robust recruitment procedures were in place which helped ensure staff were suitable to work in the care service.

Staff understood how to identify abuse and were aware of the action to take if abuse was suspected or reported. We saw safeguarding procedures had been followed when incidents had occurred. Risks to people were assessed and managed to ensure people’s safety and well-being.

We found improvements in the way people’s medicines were managed which meant people received their medicines when they needed them. However, documentation relating to prescribed creams and ‘as required’ medicines needed to be more robust. We also found action had not been taken to ensure medicines kept in the fridge were at the correct temperature.

An ongoing refurbishment programme which was implemented following the last inspection meant the premises were brighter, cleaner and better maintained than when we last visited.

A significant amount of staff training had taken place however there were still gaps where staff had not received training or updates in certain areas such as first aid, infection control and food hygiene.

The home was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and acting within the legal framework of the Mental Capacity Act (MCA).

People told us they enjoyed the food. Lunchtime was a pleasant experience with people offered choices and given the support they required from staff. People's weights were monitored to ensure they received enough to eat and drink.

People and relatives praised the staff who they described as 'good’ and 'kind'. We saw staff treated people with respect and ensured their privacy and dignity was maintained.

We saw improvements in the care records which provide more detailed and up to date information about people's care needs, although we found some information was missing or required updating.

We saw in the last few months people had enjoyed activities, which included entertainers and a trip out to a 1940s café. We found activities were limited, however an activity co-ordinator was due to start in post at the end of April 2016 which should mean better activity provision for people.

Leadership and management of the home had improved and staff praised the manager who they credited with making the improvements in the home. The manager was described by staff as supportive and approachable. Staff felt teamwork had improved which they felt had benefitted the people who used the service. Relatives we spoke with happy with the care provided.

However, quality assurance systems were not fully implemented or effective which meant systems were not in place to monitor and review progress and ensure continuous service improvement. We need to be assured that the provider will continue to provide the manager with the necessary support to ensure that the improvements made will be sustained and developed further to make sure people consistently receive high quality care.

We identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We observed people were cared for in a clean, hygienic environment. There were effective systems in place to reduce the risk and spread of infection.

People were treated by staff who were supported to deliver care safely and to an appropriate standard. Staff had a programme of on-going training, supervision and appraisal.

There were quality monitoring programmes in place, which included people giving feedback about their care, support and treatment. These were new to the service and a regular audit programme was due to start in March 2014. The audit programme would provide a good overview of the quality of the service's provided.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

On the day of our inspection we observed staff assisting people who used the service; staff were friendly, patient and polite. We saw people were dressed appropriately, looked clean and appeared well cared for. One person told us, 'It's alright now I have got used to it.' Another person told us, 'I'm settled and I feel comfortable.' However, the care plans we looked at did not contain thorough and detailed information relating to all aspects of people's care needs.

People we spoke with told us they felt safe and comfortable with staff. However, we found people who used the service were not protected from the risk of abuse because the provider had not taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We found that appropriate standards of cleanliness were not being maintained in some areas of the home.

People were treated by staff who were supported to deliver care safely and to an appropriate standard. However, staff did not have a full programme of on-going training, supervision and appraisal.

The Provider or the Manager had not monitored some important aspects of the service and checks were not always carried out. They had policies and procedures which identified what they should do to ensure effective and safe care was delivered but these were not always followed or updated.

The service held clear records about peoples care to maintain their safety and wellbeing. They kept and administered medicines safely and these were prescribed and disposed of appropriately.

The people we spoke with told us they had no complaints but if they did they would talk to the manager who would sort it out.