Background to this inspection
Updated
17 March 2023
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.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
This inspection was carried out by two inspectors, a nurse specialist 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
Parkside 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. Parkside 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 no registered manager in post. However, there was a home manager who planned to submit an application to register as manager for this service.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work 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 spoke with 4 people who used the service and 3 relatives about their experience of the care provided. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We also spoke with 8 members of staff including the manager and operations manager, nursing staff, senior care workers, care workers and the activities co-ordinator. We reviewed a range of records. This included 9 people's care records and multiple medication records. We looked at staff files in relation to, recruitment and staff supervision for two recently joined members of staff. A variety of records relating to the management of the service, including policies and procedures were also reviewed.
Updated
17 March 2023
About the service
Parkside Nursing Home is a residential care home providing personal and nursing care to up to 34 people. The service provides support to older people and those who live with dementia. At the time of our inspection there were 26 people using the service.
People’s experience of using this service and what we found
There was a lack of robust management oversight of the service. Quality assurance processes were not effective in identifying and delivering required improvements to the service which meant people were at risk of not receiving a consistent or safe service in line with their needs.
Risk assessments for those with specific healthcare conditions did not always provide consistent information around the additional care needs associated with those conditions. We found that there was an inconsistent approach to good hygiene practices. Damage to the fabric of safety equipment meant they posed an infection risk to people. Some equipment was not tailored to one person’s needs and posed an injury risk to them. The environment did not meet the needs of people who lived with dementia. In addition, certain areas of the service were in need of refurbishment.
Some people told us the quality and provision of activities was inconsistent. At times, we observed minimal staff engagement with those who were more difficult to engage as well as with those who were cared for in their rooms. We made a recommendation that the provider explores ways in which to improve communication.
People and their relatives told us they felt safe. There was robust oversight of medicines management. There were appropriate systems for recruiting, training and supporting staff. The staff felt supported and valued. We observed that they appeared to know the people they were caring for and treated them with respect.
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.
Family members told us engagement with the home had improved and the manager was approachable and readily available to them. They also told us that staff were consistently respectful, kind and caring. We observed how staff engaged with people in a warm and friendly way. Staff told us they felt supported and valued.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 28 April 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations. This service has been rated requires improvement for the last three consecutive inspections.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 01 March 2022. Breaches of legal requirements were found. We served Warning Notices in relation to Regulation 11 (Consent to care) and Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
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.
Enforcement and Recommendations
We have identified continued breaches in relation to safe care and treatment, person centred care premises and equipment and good governance.
We have made a recommendation about improving communication with people.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.