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Archived: Parklands House Care Home Inadequate

Inspection Summary


Overall summary & rating

Inadequate

Updated 12 February 2015

Parklands House provides nursing care for up to 57 people whose primary care needs are mental disorder or dementia care. Qualified nurses, supported by care assistants, provide 24-hour nursing care. At the time of our inspection there were 35 people living at the home.

This was an unannounced inspection carried out over two days, 27 and 28 October 2014. During this inspection we looked to see if outstanding breaches in regulation and the warning notice, issued on the 15 September 2014 had been met. We also looked at other areas of the service to check the provider was meeting the regulations.

The home has no registered manager. ‘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’s safety was being put at risk as the medicine management system did not demonstrate people received their medication as prescribed. We found there was a breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

Suitable arrangements to effectively maintain hygiene standards within the home and minimise the risk of cross infections were poor. We found there was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

Where people’s freedom was being restricted the management team had sought appropriate advice and support so that decisions could be made in people’s ‘best interests’. This helped to ensure people were protected. Accurate records about the individual support needs of people were not maintained. Care records did not reflect how people were being restricted, how risks were managed or reflect their changing health needs. We found there was a breach of Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

People were not always able to tell staff if they needed help. People were reliant on staff to identify any change in their health and well-being and seek appropriate help and advice. We saw where people had lost a significant amount of weight loss, this had not been acted upon. This could result in people’s healthcare needs not being met. We found there was a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

People did not receive care and support that was delivered in a dignified and timely manner. Visitors to the service told us they had witnessed people having to wait for assistance and they looked unkempt. They said people were left without staff supervision and had to seek out staff when people needed assistance. We saw staff did not always provide meaningful interactions with people. We found there was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

People were not always supported by sufficient numbers of staff to keep them safe. Due to the turnover in staff there had been a reliance on agency staff to support people. We found these staff were not aware of the individual needs of people. We found there was a breach of Regulation 22 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

Systems to monitor the quality of the service were not robust. Where audits had been completed and areas of improvement had been identified, the provider could not show us that appropriate action had been taken to improve the quality of service people received so that they were kept safe. This put people at risk of harm or injury. We found there was a breach of Regulation 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

Effective management arrangements providing clear leadership and support for staff were not in place. New staff spoke positively about working at the home and the support they had received from colleagues. However existing staff had not received updated training and support in areas specific to the needs of people living at Parklands House. We found there was a breach of Regulation 23 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

Staff recruitment processes had improved however not all checks about the suitability of staff had been completed prior to them commencing work. This puts people at risk of being cared for by staff that are unsuitable to work with vulnerable people. We found there was a breach of Regulation 21 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

People told us they liked living at the home and liked the staff. They told us they enjoyed the food and maintained relationships with family and friends. Improvements were needed so that people were effectively supported or encouraged to take part in activities specific to their needs and abilities.

Inspection areas

Safe

Inadequate

Updated 12 February 2015

The service was not safe. Systems for the management of medicines were unsafe and did not protect people using the service or ensure they received their medication as prescribed.

People were not protected against unsafe or inappropriate care as identified risks had not been assessed and planned for. Further risks to people’s safety with regards to cross infection and fire safety were not effectively managed so people were kept safe.

People did not receive the care and support they needed in a dignified and timely manner as sufficient number of staff were not always available.

People’s relatives and visiting health and social care staff said they had witnessed people having to wait for assistance. We saw, at times, people were left without staff supervision and staff did not always provide meaningful interactions

Effective

Inadequate

Updated 12 February 2015

The service was not effective. Where restrictions had been placed on people the provider had acted accordingly so that people’s rights were considered and protected. However records needed expanding upon to show how decisions had been made in people’s ‘best interest’ or how people had consented to areas of care and support

Clear and accurate information to guide staff and relevant training in areas such as Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) had not been provided, promoting good practice for staff to follow.

Staff had not accessed support from relevant health care staff, such as dieticians, so that people’s health and well-being was protected.

People were not protected from the risk of unsafe or inappropriate care as staff did not have the knowledge and skills needed to safely and effectively deliver the care people needed.

People were provided with adequate nutrition and hydration. Some people were not safely supported where they had specific dietary needs.

Caring

Inadequate

Updated 12 February 2015

The service was not caring. People were not supported in a way which promoted their dignity, choice and independence.

People’s personal information was not always kept confidential so that people’s privacy was respected.

Responsive

Inadequate

Updated 12 February 2015

The service was not responsive. Care records did not reflect people’s needs, wishes and preferences about how they wished to be cared for.

People were not afforded stimulation or variety to their day. Opportunities to take part in a range of activities both in and away from the home were limited and did not consider their specific needs and abilities.

Well-led

Inadequate

Updated 12 February 2015

The service was not well led. The provider had failed to appoint and register a manager, for some considerable time to ensure effective direction and leadership to the staff group was provided.

Effective systems were not in place to regularly monitor and review the quality of the service and facilities provided. The provider had failed to make improvements, where these had been identified, so people and their families could feel confident they would receive a good quality service.