Parkland House

Parkland House is a care home which provides accommodation and nursing care for up to 52 older people, including people living with dementia. At the time of our inspection 51 people were living at the home. The provider, Peninsula Care Homes Limited, also operates a nursing home and three further residential homes in the South West.

People's experience of using this service:

People received an outstanding, personalised, caring service. People told us they received very kind and respectful support from staff who promoted their abilities, knew them well and genuinely enjoyed their company. The whole staff group worked as a team to support people in a person-centred way.

People were valued and placed at the centre of the service. Staff promoted people's privacy and dignity and enabled them to make choices and have as much control and independence as possible building meaningful relationships.

We saw a great number of very positive compliments and praise received by the service from people, their families and friends and healthcare professionals. Feedback included, ““Yes, there’s a lot of one to one with staff. [Person’s name] gets it especially when they are feeling down”, “They are very well staffed so they can care for people really well” and “[Person’s name] has dementia. They can cry a lot and wanders about at night, but staff let them sit where they want and don’t try to coerce them back to bed. They just go with it.” Relatives all praised the consistent staff team. Relatives described staff as sensitive, kind and loving, especially when people were poorly or on return from hospital.

People received effective care and treatment from competent, knowledgeable and skilled staff who had the relevant qualifications to meet their needs. The provider had a good system to ensure all staff had regular training to keep them up to date with best practice. Training methods were relevant to the people living at the service and staff ensured they put learning into practice as well and making training links to share their own knowledge with outside agencies.

Activities were provided seven days a week and offered a wide variety of relevant and meaningful activity both inside and outside of the service. Staff got to know people and ensured activities were enjoyed and meaningful using past interests and bucket lists to enhance people’s lives individually and in groups.

The service was specifically adapted for people living with dementia. People were encouraged to be as active, occupied and engaged as possible. All the staff had been provided with dementia training and were highly skilled in responding to people’s needs. For example, encouraging involvement in household chores and activities as well as learning from people themselves.

People benefitted from having a number of people including young children and students spend time with them and excellent links with the community. This helped raise the profile of good dementia care and challenged pre-conceived ideas of living in a care home.

The registered manager and staff went above and beyond to support relatives to spend positive time with their family member, including at the end of their lives.

People had access to plenty of food and drink throughout the day and there were individualised meals according to their tastes and needs. People told us the food was very good and there was plenty of choice. Meals were appetising and served in a calm and organised manner, creating a sociable and pleasant meal experience. People all knew who the chef was and enjoyed chatting about their tastes, whilst staff promoted a cooking club, sweet shop and kitchen skills to promote healthy appetites.

The service was very well-led. The provider's quality assurance processes were effective and there was a focus on continuous improvement and continuously seeking out ways to offer personalised care and leisure time. This ensured people felt valued as individuals. The registered manager provided very good support for staff to be able to do their job effectively. They, and the provider, acted as passionate advocates and role models, especially promoting and embedding good quality care for people living with dementia in and outside the service.

More information is in Detailed Findings below.

Rating at last inspection:

Good overall

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will monitor all intelligence received about the service to inform when the next inspection should take place.

On the day of the inspection, there were a total of 50 people living at the home. There was a registered manager employed at the home. 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 and associated regulations about how the service is run.

People were supported by very kind, caring and compassionate staff who often went the extra mile to provide them with excellent, high quality care. This high standard of care enhanced people's quality of life and wellbeing.

Staff were extremely passionate about providing people with support that was based on their individual needs, goals and aspirations, and the provider and management team promoted an ethos of person centred care.

There was a strong culture within the home of treating people with respect. The staff and the registered manager listened to people, offered them choice and made them feel they mattered. People and the staff knew each other very well and these relationships were valued.

People's diverse needs were met and respected. People were able to make decisions about the support they received and live their lives as they wished.

People were safe living at Parkland House. There were enough staff to meet people's care needs safely and people received their medicines when they needed them. All staff had received appropriate specialist training and supervision to provide them with the necessary skills and knowledge to provide people with effective care.

People had access to activities, stimulation and engagement that complemented their individual hobbies and interests. This provided them with a sense of purpose and wellbeing and was at the heart of day to day life.

People received enough to eat and drink to meet their individual needs. Timely action was taken by the staff when they were concerned about people's health because they knew them so well.

The staff were happy working in the home and felt supported in their role. They were clear about their individual roles and responsibilities and they felt valued by the registered manager and the wider senior management team. Good leadership was demonstrated at all levels and there were effective systems in place to monitor the quality and safety of the care provided. People living at the home and staff saw each other as one team together.

Before our inspection we reviewed all the information we held about the home. We examined previous inspection reports and notifications received by the Care Quality Commission.

On the day of our visit there were 52 people living at Parkland House. We met with ten people, three relatives, the registered manager, activity co-ordinators and six staff to find out if the care and services people received met their needs. We also spoke with a community psychiatric nurse who spoke positively about the services provided at Parkland House. Most people we spent time with who lived at the home were unable to tell us directly about their experiences due to living with dementia so we spent time observing care in the communal areas and in the garden. We looked at the care files of four people living at the home, spent time with them and observed their care.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

Is the service safe?

The service was safe because people's health and care needs were understood by a trained and well supported staff. Risks to people's health and welfare were understood and managed in line with their agreement. A health professional told us 'This is one of the best homes for people with dementia I have been in. They are so caring and work well with us'.

There was monitoring of events and incidents and measures were put in place to minimise any identified risks such as falls and skin damage.

Care plans included considerations of the Mental Capacity Act (2005) such as best interest decision making and staff demonstrated an understanding of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS) and how they applied to their practice. We found the location to be meeting the requirements of the Mental Capacity Act (2005). People's human rights were therefore properly recognised, respected and promoted and appropriate family/advocates were involved.

Is the service effective?

The service was effective because people's health and well-being was promoted. Care plans provided instructions to staff about the care each person wanted and needed. Staff were very knowledgeable about people's individual needs. However, although care plans overall contained the information about how to meet people's needs, the layout of the care files did not lend itself to an easily accessible person centred approach. We saw evidence of multi-professional visits and appointments in a timely way, for example GP, speech and language therapist, and community psychiatric nurses and that advice was followed and recorded.

Is the service caring?

The service was caring because we saw staff communicating in a warm and caring manner. For example, some people living with dementia had complex needs. We saw staff were always visible and attentive to people, noticing their needs expressed by body language. The staff ensured that people's anxiety and behaviour that could be challenging to staff was minimised using distraction techniques. People were well cared for and offered regular drinks and were regularly checked if they were in their rooms. There were lots of interaction between staff and people living at the home and a clear programme of activities and stimulation on offer which was tailored to meet individual needs.

Is the service responsive?

The service was responsive because people's likes and dislikes were taken into account. Care was person centred and staff were seen to be meeting people's individual needs. For example, we saw people who were going out with relatives, were all ready to go and one person was seen playing a board game which their care plan stated they liked to do, they were laughing and enjoying the time with staff. We saw people being assisted to get up at the time stated in their care plan or when they wished on the day.

The staff we spoke with understood each person's needs. They were able to describe people's preferences and showed sensitivity to each person's needs. On the day of our visit it was a warm day so staff monitored the room temperatures and then went out to buy ice cream and sodas for everyone, which some people enjoyed in the garden.

Care files were regularly updated and short and long term health needs were monitored and actions taken appropriately.

Is the service well-led?

The registered manager showed us monitoring forms which provided evidence of regular checks carried out to ensure all aspects of the service were safe and ran smoothly.

Staff told us they were confident the management arrangements worked well and that the service was well-led and their views were listened to. All staff told us they felt well supported and valued. Staff meetings and staff supervision sessions were held regularly enabling staff to have one to one sessions in a formal way. All meetings were recorded and this showed that people and staff could raise matters about the service and know their views were valued.

People told us they were very happy about how care and support was provided to them, and with the staff who provided that care. We observed there was a friendly and welcoming atmosphere. People told us that they liked living in the home. One said 'They come straight away and they are so kind. They wash your clothes and iron them for you. I am as happy as I can be here'..I have all the help I need'.good food'.cosy bed'lots of company and my family down the road. I'm very lucky to be here!' Another said 'You've only got to ask and they will help.' We observed people had good relationships with the staff. People and staff interacted well. One relative told us 'It's absolutely perfect. I can't fault it. Staff are wonderful.'

We found people's nutritional needs were well met and there were sufficient staff to meet people's health and welfare needs. There was a complaints system in place that people were aware of. Where a complaint had been received, lessons had been learnt and staff informed. We looked at records relating to the people who lived at Parkland House, and following concerns included this outcome in our inspection. We found that whilst care was delivered appropriately, care records did not reflect peoples care needs. Staff records and records relating to the management of the services were accurate and fit for purpose.