Parkview Nursing Home

Parkview Nursing Home is a residential care home providing personal and nursing care to up to 87 people. The service provides support to adults living with dementia. At the time of our inspection there were 86 people using the service.

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

People and their families described the care as good and people were supported and treated with dignity and respect. The feedback was positive about the caring nature of staff and their compassionate approach.

People were involved in decisions about their day to day lives and staff respected people's choices. An activities coordinator worked well with people to try to ensure there was a wide range of appropriate activities people could involve themselves in. People’s dignity and privacy was respected.

People's diversity and their individual needs were respected by staff. The staff team knew people well and were able to provide appropriate support discreetly and with compassion.

People were supported to maintain contact with relatives and friends.

People were kept safe. Staff demonstrated they knew how to raise safeguarding concerns and were aware of the processes to follow in order to keep people safe. People told us they were kept safe and that they felt safe.

Care and support plans were developed to ensure people’s needs and risks were met appropriately.

Risk management strategies were in place to assist staff to help people to manage identified risks which included identifying triggers for behaviours that may cause distress. Risk management plans helped staff as well as the person to minimise risks but included positive risk taking.

Staffing levels were good and appropriate to ensure people's needs were met in a safe, timely and consistent way.

The service was following safe infection prevention and control procedures to keep people safe.

The administration of medicines was managed in a safe way. There were policies and procedures in place for staff to follow and staff told us they found them useful in ensuring people received their medicines safely.

Staff were provided with the right training and support to make sure they could fulfil their roles appropriately.

There was clear evidence of collaborative working and good communication with other professionals in the health and social care sector.

People's health care needs were being met and they had access to healthcare services where needed.

People were supported to have as much choice and control of their lives as they could achieve. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Appropriate policies and procedures were in place to manage and respond to complaints and concerns.

The provider's ethos and values put people at the heart of the service. The staff team were empowered to contribute to support a person-centred model of effective care. This helped people using the service to achieve their maximum potential and quality of life.

There was a comprehensive and effective governance system in place.

People, relatives and staff were confident about approaching the registered manager if they needed to. They recognised that their views and feedback were valued and respected and consistently used to support quality service development.

A wide range of comprehensive audits took place to ensure the quality of the service was maintained.

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 February 2019).

Why we inspected

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

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.

Follow up

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 was following best practice guidance to prevent visitors to the home spreading COVID-19 infection. The provider kept in touch with family members and people's friends through regular email newsletters. The provider said that when visitors booked for an appointment to see the residents they were sent the latest information on visiting procedures.

The provider had arrangements for visitors to meet with people in dedicated meeting rooms. All visitors were asked to complete a COVID-19 screening form on arrival, and had their temperature checked. Visitors had to undertake a lateral flow test on arrival and visiting professionals had to show proof of a negative lateral flow test taken on the day of the visit; in addition, all visitors had to show proof of their COVID-19 vaccination. People were supported to see their family in the garden during summer.

In order to control the spread of infection the provider promoted social distancing in the lounge and dining areas. The provider informed us that staff used Personal Protective Equipment (PPE) including gloves, mask and apron when providing personal care and when social distancing was not possible.

All COVID-19 positive service users were isolated according to Public Health England Guidelines. The provider informed us if a resident tested positive, they were isolated and were allocated a dedicated staff support team.

The provider had an admissions process in place. The provider informed us that as soon as the service users arrived they performed a lateral flow test and a PCR test was undertaken on the day of admission into the service. The provider informed us that all new service users were usually isolated for 10 days; however, if the service users had received two doses of the COVID-19 vaccine and received a negative COVID-19 PCR test after admission, they were not required to isolate.

The home had PPE stations for staff to don and doff (put on and take off) Personal Protective Equipment (PPE).

Our observations during the inspection confirmed staff were adhering to PPE and social distancing guidance.

The provider informed us that all staff had received infection prevention and control and personal protective equipment training. The provider had an Infection Prevention and Control (IPC) champion who attended regular meetings with other IPC champions in the local area and shared their learning with all care staff.

The provider informed us that all staff undertook COVID-19 lateral flow tests before each working shift. The provider confirmed us that all staff working at the service had received the first two doses of a COVID-19 vaccine and most of the staff had received their booster dose. The provider informed us that all but two residents had received their booster dose. The provider maintained a vaccination and testing register for staff and service users.

The provider had ensured staff who were more vulnerable to COVID-19 had been assessed and plans were in place to minimise the risk to their health and wellbeing. The provider informed us that they had an open-door policy and had regular meetings with staff. The care home manager indicated they had a really good support system in place and were supported by the management.

Further information is in the detailed findings below.

We found the following examples of good practice.

The provider supported people to maintain links with family and friends. Visitors were able to use a visitors’ pod that enabled them to see people without increasing the risk of spreading infections. Visits were pre-booked and restricted to half an hour and the area was deep cleaned between visits. Hand sanitiser stations were available throughout the home.

The provider had appropriate arrangements to help prevent the spread of Covid 19 for visits to people at the end of their lives. Visitors were required to wash their hands, have their temperatures taken and complete a Covid 19 risk assessment, which included screening for symptoms of Covid 19, before being allowed to enter the home.

The provider had appropriate arrangements to test people and staff for Covid 19 and was following government guidance on testing. This ensured people and staff were tested for Covid 19 so appropriate action could be taken if any cases were identified.

The provider ensured all their staff received appropriate training and support to understand and manage Covid 19. This included best practice for infection control and the use of PPE.

Staff also received appropriate guidance on how to support people with dementia to understand the pandemic and Covid 19. Separate teams of staff were allocated to each floor of the home to reduce the potential spread of infections.

The provider made appropriate support services available to staff in order to support their mental wellbeing through the pandemic and if they became unwell and when they returned to work.

Further information is in the detailed findings below.

Parkview Nursing Home provides accommodation with nursing and personal care for up to 88 older people, some of whom have dementia. At the time of this inspection there were 77 people using this service. Accommodation is provided over three floors with two modern lifts enabling access around the building. There were large communal lounges on each floor and dining rooms that were also used to provide day care during the week. The garden was well maintained and accessible for people.

Staff knew how to keep people safe and demonstrated a good knowledge of how to recognise abuse. Risk assessments were developed to minimise the potential risk of harm to people during the delivery of their care while still encouraging people to be as independent as possible. There were systems in place for the safe storage, administration and recording of medicines. Staff were recruited safely with appropriate checks on their backgrounds completed. All staff completed an induction programme and on-going training was provided to ensure skills and knowledge were kept up to date. All areas of the service were clean and well maintained. Cleaning schedules were in place and staff had access to personal protective equipment when required.

People’s needs were assessed and met by trained, supervised and appraised staff. People’s mental capacity was assessed and supported. People ate well and staff supported them to access healthcare services as necessary.

People and relatives told us staff were caring and kind. Staff respected people’s privacy and dignity and promoted their independence. People and staff shared positive relationships and visitors were made to feel welcome at the service.

Staff were responsive to people’s changing needs. People’s healthcare needs were detailed in their care plans. People engaged in a range of activities made available at the service. The provider managed complaints appropriately. Staff ensured that people were cared for compassionately at the end of their lives and in line with their preferences.

The service was committed to improving the robustness of its quality assurance processes so that action was taken where shortfalls were identified. Staff felt supported by the registered manager and encouraged to share their views regarding improvements to the service. The provider sought and responded to feedback from people and relatives and made information available to them. People benefitted from the provider’s partnership working with external organisations.

The home had a 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 and associated Regulations about how the service is run. The registered manager was present on duty for the inspection.

The service had procedures in place whereby they assessed and identified risks to people’s health and safety. Appropriate risk management and support plans were developed to respond and to guide staff on how to keep people safe. Risk assessments and support plans were reviewed every month or where the person’s care needs had changed. Staff knew how to keep people safe and how to recognise signs of abuse. People and staff told us and we saw that there were sufficient staff numbers to meet people’s needs but acknowledged there were staffing shortages earlier this year which were now resolved.

People were supported by staff who were appropriately trained and skilled to meet their needs. Staff upheld people's rights and supported them in line with the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Staff followed protocols and ensured people who lacked mental capacity were not unlawfully deprived of their liberty.

People told us they enjoyed the food and they got a choice. People’s nutritional needs were being met. People had access to outside health professionals when their health needs changed, but the service delivered by some community health professionals was not always satisfactory.

People and their relatives told us that this was a happy place to live. Staff provided people with the care and support they needed, this was delivered in a respectful way.

The home employed two activity coordinators; activities were available to all people living in the home. People were offered variety and could join in the numerous activities provided if they wished.

Staff were supported appropriately in their roles which enabled them to plan and deliver people’s care competently. The provider ensured suitable staff were recruited and appointed using robust recruitment procedures.

People using the service felt able to speak with the registered manager and provided feedback on the service. They knew how to make complaints and there was a complaints policy and procedure in place.

Areas of the environment were not satisfactory such as flooring, decor and a number of bathrooms required improvement. These had been identified by the provider and work was in progress in replacing flooring and attending to other areas of the environment indoors and maintaining the garden.

The organisation had systems in place to monitor the quality of the service, and we found these helped drive improvements. Feedback was obtained from people and areas for improvement were actioned as appropriate.

From the surveys we looked at most people were satisfied with the care provided. Comments we saw ranged from, 'My carer is good.', 'Some staff are better than others but are helpful in general.', 'The staff seem caring and friendly.' and 'We feel all aspects are fully satisfactory.'

We observed from people's records their care and support needs had been assessed and plans were in place to meet these needs. Risks to their health and wellbeing had been identified and plans were in place to manage these. We noted information about people was reviewed and updated regularly so staff had up to date information about people's current care and support needs. Staff received appropriate training to keep their skills and knowledge up to date to meet these needs.

Medicines were administered appropriately and stored safely in the home.

People were provided with information about how to make a complaint if they were not happy with the service. Their views and experiences were sought and acted on by staff. The service had systems in place to monitor the quality of service that people received.