Archived: Parkfield Rest Home

We last inspected the service in May 2014 where we found that they were meeting all the regulations we inspected.

The provider was in day to day charge of the home and as such, there was no requirement for Parkfield Rest Home to have a registered manager in post under their registration with the Commission. The provider told us she was a non-practising nurse and had also completed catering qualifications.

The provider opened the home in 1984. She explained that the home had been up for sale for six years and they were “winding down.”

Two people were living at the home at the time of the inspection. They had lived at the home since 2002. Only part of the home was being used due to the small number of people living there.

We spent time looking around the home and found that not all areas were well maintained. In addition, there were shortfalls in infection control procedures. Risk assessments had not been carried out to assess risks relating to the premises and risk assessments for people were limited.

We had concerns with staffing levels since there was only the provider and senior care worker through the week to provide 24 hour care.

People told us that they felt safe. There was a safeguarding policy in place. This had not been updated in line with recent legislation and West Yorkshire’s reporting procedures. The provider had not completed safeguarding training and the senior care worker had not undertaken safeguarding adults training since 2006. There were shortfalls with certain aspects of medicines management.

Supervision and appraisals were not documented. The senior care worker had not completed any training since 2006 and there was no evidence that specific training to meet the needs of people who lived at the home had been carried out.

There was no evidence that people had consented to their care and support. During our inspection, it was not always clear whether people’s preferences were taken into account.

We checked whether people’s nutritional needs were met. The senior care worker informed us that one person required a soft diet because of an incident which had occurred in 2006. There was no evidence that advice had not been sought from a dietitian or speech and language therapist to make sure that the person was receiving a suitable diet. We noted that this person had lost weight in February 2016. There was no evidence that the person’s weight had been rechecked or action taken to reduce the risk of any further weight loss.

It was difficult to find out when people had accessed health care services because this was recorded in copious amounts of daily records. Staff had recorded that it was not necessary for people to see a dentist because they did not have any teeth and did not wear dentures. We considered however, that oral health checks should still be carried out to check there were no irregularities or oral health concerns.

We observed that some interactions between the provider and one individual were not person centred. In addition, the language and terminology used in daily reports did not always promote one person’s dignity.

Although staff informed us that people’s needs were met in a person centred way; there was limited information in both people’s care files to document this care and support. There were no formal arrangements in place for people to have their individual needs regularly assessed and reviewed. The senior care worker told us that this was ongoing.

There was a complaints procedure in place, however, this did not include all relevant information such as up to date contact details about who to contact.

There were no formal systems in place to obtain the views people. The provider said, “They don’t like formal systems. We are with them all the time.”

There were no systems in place to monitor the quality of the service. The provider informed us that informal undocumented checks were carried out. We identified serious shortfalls with the maintenance of records relating to people, the management of staff and the management of the service. Policies and procedures had not been updated in line with changes in legislation and best practice guidelines.

We had not been notified of certain events and incidents at the service which the provider is legally required to do. The provider was unaware of her responsibilities to do this.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

We found multiple breaches of the Health and Social Care Act 2008. Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, staff supporting them and from looking at records.

Is the service safe?

People told us they felt safe. Safeguarding procedures were robust and staff we spoke with understood how to safeguard the people they supported.

Equipment was well maintained and serviced regularly therefore not putting people at unnecessary risk.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in writing their plans of care.

People's needs were taken into account with signage and the layout of the service enabling people to move around freely and safely. The premises had been sensitively adapted to meet the needs of people with physical impairments.

Is the service caring?

People were supported by kind and attentive staff. We saw care workers showed patience and gave encouragement when supporting people. People commented, 'It's lovely here.' Another said, ' I wouldn't go anywhere else, the staff look after me well'.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People completed a range of activities in and outside the service regularly.

People using the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

People knew how to complain if they were unhappy. People told us they had never needed to make a complaint but if they did they thought complaints would be investigated and action taken as necessary.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

Staff had attended several training courses which took into account the needs of the people who used the service. This ensured that people's needs were met.

We had the opportunity to speak with both people who used the service. They told us they were happy with the care and treatment provided.

Their comments included: "It is alright here, I like my bed", 'I enjoy watching TV' and 'I go out to the shops'.

We found the provider had appropriate systems in place to ensure consent was gained before they proceeded with personal care. The provider had taken steps which ensured the care and welfare of people who used the service. There were arrangements in place to deal with accidents.

We saw evidence there was an appropriate system in place for listening to and acting on people's comments and concerns.

We judged that although the home was in the process of being sold the two people using the service received appropriate care and were looked after well.

Both the people told us they felt well cared for. One person told us "I like living here I am well looked after and get good meals."

We judged that although the home is for sale the two people using the service received good care and were well looked after.