Parker House Nursing Home

Updated 23 January 2024

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 1 inspector, a specialist nurse advisor, and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Parker House Nursing Home is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Parker House Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority and integrated care board who commission care with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We visited the service on 28 and 29 November 2023. We also made phone calls to relatives on 30 November 2023. We spoke with 8 staff members including the registered manager, clinical lead, registered nurse, senior care staff, care staff, registered nurse, and the cook. We spoke with 1 visiting healthcare professional. We spoke with 3 people who used the service and 7 people's relatives. Not everyone living at the service was able to or wanted to speak with us, therefore we spent time observing interactions between staff and people. We reviewed a range of records. This included 9 peoples care records and multiple medicine records. We looked at 4 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including audits, policies and training records were reviewed.

Updated 23 January 2024

Parker House Nursing Home is a residential care home providing regulated activities personal and nursing care to up to 25 people. The service provides support to mainly older adults some of whom were living with dementia. At the time of our inspection there were 24 people using the service. Support is provided in one adapted building across two floors with lounges on the ground floor.

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

Risks were not consistently managed or monitored. This placed people at an increased risk of avoidable harm. Risks relating to people's environment were inconsistently managed. Medicines were not always managed safely. People were not always protected from the risk of infection as staff were not consistently following safe infection prevention and control practices. People and their relatives told us they felt safe living at the service. Lessons were not always learnt following incidents. This meant there was an increased risk incidents could be repeated.

Staff were not always recruited safely, and we found the provider did not always ensure there were enough suitable staff to support people in a timely manner. The provider took immediate action to ensure safe staffing levels were in place. We have recommended the provider reviews their recruitment process to ensure all staff are safely recruited.

Internal quality assurance processes were not effective in monitoring the service. Health and safety audits were not always effective in monitoring safety and driving service improvement. People and their relatives were inconsistently involved in developing the service. The culture at the home was not always person centred. Relatives we spoke with told us they were informed when things went wrong. Staff worked in partnership with others.

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

The last rating for this service was good (published 28 October 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We carried out a focused inspection to review the key questions safe and well led. 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 have found evidence that the provider needs to make improvements. Please see the safe and well-led section of this full report. You can see what action we have asked the provider to take at the end of this full report.

During our inspection the provider took some action to address the concerns we found to mitigate risks. Risk reduction measures implemented during our inspection were found to be effective in managing some of the risks we identified.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Parker House Nursing Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to medicines, infection control, management of risk, the premises and quality monitoring of the service at this inspection. We have also recommended the provider reviews their recruitment process.

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.