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Inspection Summary


Overall summary & rating

Good

Updated 31 August 2018

We carried out an unannounced inspection of this service on 18 and 19 July 2018. Park View is a care home providing accommodation and nursing care for 108 adults including younger adults who may have a diagnosis of dementia. At the time of our inspection 108 people were living in the service.

People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. This service provides personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a registered manager in post. At the time of the inspection there had not been a registered manager in post for 100 days. 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.

At our last inspection on 18, 19, 21 and 28 July 2017, the service was rated 'Requires Improvement'. We identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider did not always have plans in place for managing risks people faced. The provider did not always manage and administer medicines safely, and guidance for how to administer medicines covertly was not always clear and some decision forms were incomplete. There was not enough suitably qualified, competent, skilled and experienced staff in place to meet the requirements of people using the service. The provider did not ensure staff received appropriate support, training, professional development and supervision necessary to enable them to carry out their duties. Quality assurance systems and audits had not operated to assess and improve the quality and safety of the service provided.

At this inspection we found that these breaches had been addressed.

People using the service and their relatives said the service provided safe care and treatment. The service managed medicines safely. However, not all ‘decision to administer’ forms were updated to match people’s changing prescriptions and not all medicines were disposed of appropriately. The acting manager addressed these concerns following the inspection. There were sufficient numbers of suitable staff employed by the service. Staff had been recruited safely with appropriate checks on their backgrounds completed. People were protected by the prevention and control of infection. There were robust procedures in place to protect people from harm and staff were clear on how to recognise and report abuse. The provider assessed and managed risks to people in a way that considered their individual needs.

Staff understood the Mental Capacity Act 2005 (MCA). MCA is law protecting people who are unable to make decisions for themselves and where people were not able to do this, the appropriate authorisation procedures had been completed. These are referred to as the Deprivation of Liberty Safeguards (DoLS).

Staff undertook training and received regular supervision to help support them to provide effective care. People were encouraged to live a healthy lifestyle and received holistic support from various health and social care professionals.

People and their relatives told us staff supported them or their relative with dignity and respect. They ensured people’s privacy was maintained particularly when being supported with their personal care needs. People were supported to be as independent as possible and staff supported them in the least restrictive way possible. People and their relatives felt involved in the running of the service and could have an input into the care provided.

Each person had an individual care plan. However, these care plans were not always up to date and did not always reflect people’s support needs. The acting mana

Inspection areas

Safe

Good

Updated 31 August 2018

The service was safe.

Medicines were managed safely. However not all ‘decision to administer’ forms had been updated to reflect people’s changing prescriptions.

Staffing levels were appropriate and staff had been recruited in a safe manner to ensure people in the home were safe from harm.

Staff were aware of safeguarding procedures and knew how to identify and report abuse.

Risk assessments were in place and ensured risks to people were managed and people were safe.

There were systems in place to reduce the spread of infection.

The service monitored all accidents and incidents and learnt lessons to prevent future instances of people being at risk of harm.

Effective

Good

Updated 31 August 2018

The service was effective.

MCA assessments had been carried out to check if people had capacity to make certain decisions. The acting manager and staff were aware of the principles of the MCA and supported people in line with their best interests.

Staff had the knowledge, training and skills to care for people effectively.

Staff received supervisions and felt supported in their role.

People’s needs and choices were assessed to deliver personalised and effective support.

People were encouraged to live a healthy lifestyle and were in touch with health and social care professionals to keep them well.

Caring

Good

Updated 31 August 2018

The service was caring.

Staff understood the principles around equality and diversity and ensured all people felt comfortable and supported.

People received support from staff that was caring and person-centred.

People and relatives were involved in decisions about the care and support they received.

People’s privacy and dignity was respected.

People were encouraged and supported to be as independent as possible.

Responsive

Requires improvement

Updated 31 August 2018

The service was not always responsive.

Care plans were not always updated to reflect people’s changing support needs. They did not always include information on how to support people.

Staff did not always have a good understanding of people’s support needs.

The service did not always provide enough meaningful activities for people.

The service supported people at the end of their life to be comfortable and took into consideration their wishes.

The service responded to all complaints and people were confident with raising concerns.

Well-led

Good

Updated 31 August 2018

The service was well-led.

Quality assurance systems were in place for continuous improvements to be made.

Staff were positive about the acting manager and felt the service was well-led.

People and their relatives could provide feedback about the service and this was being acted upon to develop the service.