Archived: Park Avenue Care Home

Park Avenue is located in the Oakwood/Roundhay area of Leeds. It provides nursing care for up to 43 older people, some of whom are living with dementia. It is close to local amenities and is accessible by public transport.

There was a registered manager in post. 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.

We saw positive interactions throughout our visit and people were happy and comfortable with the staff. People’s relatives told us they felt their family members were safe and well looked after at the home. A relative said they had confidence in the service and told us they had a sense of security and ease from this. Staff showed a good understanding of safeguarding vulnerable adults and knew what to do to keep people safe from abuse. The registered provider had a range of systems which ensured risk was well managed and included health and safety around the home, safe recruitment of workers, accident and incident management and management of medicines.

There were enough staff to meet people’s needs. Staff responded to people’s individual needs and delivered personalised care; they knew the people they were supporting well. This meant people received consistent support. We saw staff treated people with dignity and respect and supported people in a calm, compassionate and caring way. People’s needs had been assessed well and support plans contained good information which guided staff on how care should be delivered in a person centred way.

Staff were well trained, supervised and appraised which meant they were able to carry out their role effectively. Staff were cheerful and friendly and spoke highly of how much they enjoyed their job. They showed a genuine commitment to people who lived in the home. People had opportunities to take part in activities of their choice. There was a good range of well organised activity for people.

There were policies and procedures in place in relation to the Mental Capacity Act (MCA) 2005. Staff were trained in the principles of the MCA and could describe how people were supported to make decisions; and where people did not have the capacity; decisions were made in their best interests.

We saw people were provided with a choice of healthy food and drinks which helped to ensure their nutritional needs were met. People enjoyed the food and had plenty to eat and drink. People were supported to maintain good health and had access to healthcare professionals and services.

People were aware of how to complain and told us they knew who to contact if they were not satisfied. People did not raise any issues about the service and told us if they did have any concerns they would discuss these with staff or the management team. The registered manager had dealt appropriately with any complaints received.

Effective systems for monitoring the quality of the service were in place. We saw the registered manager had a visible presence in the home. Staff spoke positively about the leadership of the registered manager and we found there was a positive culture within the service. People who used the service and their relatives were involved in a meaningful way to help drive improvements in the service. They told us they attended meetings and felt confident to raise any issues or concerns they had.

We told the provider they needed to take action and we received a report setting out the action they would take to meet the regulations. At this inspection we found improvements had been made with regard to these breaches. However, we found other areas where improvements were needed.

Park Avenue is located in the Oakwood/Roundhay area of Leeds. It provides nursing care for up to 43 older people, some of whom are living with dementia. It is close to local amenities and is accessible by public transport.

There was a registered manager in post. 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.

At this inspection we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Plans for responding to emergency situations were not fully understood by staff and the policy for resuscitation was not clear on the actions to be taken in the event of cardio-pulmonary resuscitation (CPR.) Staff did not receive appropriate support through a robust programme of supervision to enable them to perform duties they were employed to perform. You can see what action we told the registered persons to take in relation to each of these breaches of the regulations at the end of the full version of this report.

We found improvements were needed to ensure the meal time experience for people who used the service was a positive one. People did not get well organised support at meal times. People did say the food was appetising.

The premises were well maintained to ensure people’s safety. However, the environment in the upstairs floor of the home did not always meet the needs of people who were living with dementia. The communal space available was small and cramped.

Relatives of people who used the service said their family members were safe and well looked after at the home. They spoke highly of the staff and the care they provided. Staff had a good understanding of safeguarding vulnerable adults and knew what to do to keep people safe. Staff were recruited appropriately in order to ensure they were suitable to work within the home. They were provided with training to develop their knowledge and skills. However, some staff were not fully aware of the needs and preferences of people who used the service, which meant person centred care was not always provided.

The registered manager and staff understood the requirements of the Mental Capacity Act 2005. The care plans we looked at contained mental capacity assessments where appropriate.

People were supported by staff who treated them with kindness and were respectful of their privacy and dignity. There was opportunity for people to be involved in a range of activities; however, on the day of our visit, there was no provision for people on the first floor.

There were systems in place to ensure complaints and concerns were fully investigated. People had the opportunity to say what they thought about the service and the feedback gave the provider an opportunity for learning and improvement.

Overall there were effective systems in place which ensured people received safe care. However we found some records were difficult to decipher due to illegible hand writing within them.

Staff and relatives of people who used the service spoke highly of the management of the home. We observed there was at times a lack of leadership and direction from senior staff in charge of each floor of the home.

Below is the summary of what we found but if you want to see the evidence supporting our summary please read our full report. The summary is based on speaking with people who used the service, the staff supporting them, our observations and from looking at records.

We also used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Is the service safe?

We saw that people who used the service were happy and comfortable with staff in their interaction with them.

Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

In the main, people said they felt safe at the home. One person said, 'I never feel frightened here.' A relative said, 'Mum is safe secure, there is nothing to feel unsafe about.' However, one person's relative said they thought the supervision of communal rooms in the home could be better to ensure people's safety. We also saw there was an occasion when a communal room was left unsupervised and people who used the service were put at risk from falls.

Care and support was not always planned and delivered in a way that was intended to ensure people's safety and welfare. Gaps and omissions in care plan and risk management plans could lead to people's needs being missed or overlooked.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. We saw that appropriate applications had been made when it was identified people's liberty may be deprived.

Systems were in place to make sure learning from events such as complaints, accidents, incidents and safeguarding investigations took place. This reduced the risks to people and made sure the service continually improved.

Is the service effective?

Care records showed that people had regular contact with health and other professionals. Specialist dietary, mobility and equipment needs had been identified in care plans when required.

People were cared for by staff who were supported to deliver care to an appropriate standard. Training records showed most staff in the home had completed mandatory training and other appropriate training to meet people's care and support needs. This included dementia care.

Is the service caring?

In the main, people were treated with respect and dignity by staff. Comments from people who used the service or their relatives included:

'Mum always seems well cared for, nicely dressed, good with her dignity.'

People who used the service or their relatives told us they were happy with the care and support received. One person who used the service said, 'They are all very lovely here.' Another said, 'I am a bit bedfast at the moment but they always come when I need them.' A relative told us, 'Staff treat people well, they are kind.'

We saw overall that care practices were good. We saw that people were happy, relaxed and comfortable with staff in their interaction with them. There was, in the main, positive interaction and it was clear that staff were aware of the needs and wishes of the people who used the service.

Is the service responsive?

People who used the service or their relatives told us they knew how to complain or raise concerns if they had any. We looked at complaints records to see how they were dealt with. We found they had been investigated thoroughly and people were responded to in a timely manner.

We saw that people who used the service were responded to promptly when they asked for any support or assistance.

People were supported to be involved in a good selection of activity of their choice within the home.

Is the service well led?

Staff said they felt the service was well managed and the Registered Manager was approachable. They said they had confidence that any issues brought to their attention were always dealt with properly and thoroughly. Staff said they understood their role and what was expected of them.

There was an effective system in place to regularly assess and monitor the quality of the service that people received. We looked at reports and records which showed the provider had assessed and monitored the quality of service provision.

People who used the service or their relatives were positive about the care provided for themselves or their family member. They said they were treated well. Comments included:

'It's alright here, it's nice.'

'I've never had cause for concern. We know (name of Manager) and (name of Deputy Manager) really well. I'd feel able to speak with either of them about anything.'

'I think she is alright here'.

We saw that people who used the service were happy and comfortable with staff in their interaction with them. We saw that people were chatty, smiling and appeared relaxed and comfortable with staff and others living in the home.

We spoke with six members of staff who were all able to give examples and explain how they respected people's dignity, privacy and confidentiality. They spoke of the importance of treating people as individuals.

Staff said they treated people who used the service well and that any untoward practices would not be tolerated and reported promptly. They were aware of the action to be taken to safeguard people from abuse or neglect. A person who used the service said, 'I feel safe when (name of nurse) is on. She's lovely, I really like her. She always says to me, 'Goodnight and God Bless' and I say the same back.'

We found that the care records of people who used the service had improved. People's needs were identified well and action taken to monitor and meet people's needs was documented.

We saw that overall, people were cared for in a clean, hygienic environment. One person's relative said, 'The home was showing its age but I think the day to day cleaning is good. I'm pleased with all the work they are doing to improve it.'

There were now effective systems in place to make sure the safety and quality of the service was monitored.