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Inspection carried out on 6 February 2018

During a routine inspection

Parkview is a ‘care home’. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Parkview accommodates 86 people across four separate units, each of which have separate adapted facilities. One of the units specialises in providing care to people living with dementia.

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 2008 and associated Regulations about how the service is run.

At the last inspection, the service was rated Good. At this inspection, we found the service remained Good.

People remained safe at the service. Checks were carried out on staff before they started work with people to assess their suitability to care for vulnerable people. Staff understood their role and responsibilities to keep people safe from harm.

Staff had a good understanding of risks associated with people's care needs and how to support them. Medicines were stored and administered safely, and people received their medicines as prescribed. Regular audits ensured medicines were managed in line with good practice guidelines.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. The management and staff team understood the principles of the Mental Capacity Act 2005 (MCA) and

Deprivation of Liberty Safeguards (DoLS).

People were cared for and supported by staff that understood their needs and knew them well. Staff treated people with dignity and respect and were sensitive to their needs regarding equality, diversity and their human rights. The care and support people received was individualised. They were offered a range of activities both at the service and in the local community.

There was a clear management structure in place. The manager and other senior staff were well liked and respected by people and staff.

There was a friendly, relaxed atmosphere and staff were kind and attentive in their approach. It was clear from the chatter and laughter at lunchtime that mealtimes were relaxed and informal. People told us, and we could see for ourselves, that they could choose what to eat from a choice of freshly prepared food.

The registered manager sought feedback about the quality of the service provided to people and/or family members, staff and visiting health professionals. There was an on-going quality monitoring process in place to identify areas of improvement required within the service. Action was taken when an area for improvement had been identified.

Inspection carried out on 25 & 26 November 2015

During a routine inspection

This inspection took place on 25 and 26 November 2015 and the first day was unannounced. The last inspection of this service took place on 24 June 2014 and was meeting all the required standards inspected.

Park View provides care and accommodation for up to 80 people and some people will have a diagnosis of dementia. On the days of our inspection there were 79 people present.

There was a registered manager in place. 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.

The provider had a range of systems in place for the good management and governance of the service. They were following policies and procedures and gathered information which informed the manager and staff of what was going on in the service and any actions to take in response to any difficulties encountered. This included increasing staffing in response to identified individual need.

Staff interacted with people in a caring and professional way. People were supported to attend religious services if they wished to do so. Staff talked with people individually and in groups using photographs to stimulate memories. Each person had a person-centred care plan which identified their specific needs and actions for staff to take to support people. This included taking people for walks and shopping trips.

People living at the service, staff and visitors described the management of the service as open and approachable. The management team had supported staff to identify interests and skills which they had supported with training. This meant that a number of staff champions had been appointed in various areas and performed activities to develop additional knowledge for the benefit of staff colleagues and upon which people of the service could call.

People had their mental health and physical needs monitored. The service had identified as necessary accurate recording of food and fluid charts for people. This had been achieved through staff meetings and training workshops, plus working with local professionals. Staff were confident in how to monitor and respond appropriately to peoples identified needs and their nutrition needs had improved.

The service provided training in the form of an induction to new staff and comprehensive on-going training to existing staff. The senior staff of the service were knowledgeable with regard to Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The service had made referrals and worked with the Local authority to support people who used the service with regard to (MCA) and (DoLS).

People who used the service felt safe and secure. Staff spoken with, knew how to keep people safe and report any allegations of safeguarding and were confident they would be fully investigated to ensure people were protected. Staff received supervision and an appraisal.

The manager monitored the service through the use of a manager’s weekly key performance indicators report. In turn this led to the overseeing of risk assessments and resulting plans of care had been recorded in the individuals care record. The staff had worked well with the GP Practices to ensure that the best healthcare available was provided to the people who used the service.

Throughout the inspection we saw that peoples consent was sought and dignity respected. Each person had a care plan which was regularly reviewed and changes recorded as necessary and acted upon.

The service had a complaints process in place and the management undertook regular audits and surveys to identify issues and how the service could be improved.

The service had a mission statement and the vision and values of the service were focussed on providing person-centred care and treatment. The staff were attentive to detail as lead by the management of the service setting the example, so that things that mattered to the people using the service were attended to.

The management of the service provided an on-call system to support staff at the service if so required.

Inspection carried out on 24 June 2014

During a routine inspection

We spoke with two people who used the service, four visiting relatives, and four staff including the registered manager. We looked at six people's care records. Other records viewed included staff training records, health and safety and quality checks and satisfaction survey results.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

We saw that the staff were provided with regular training in safeguarding vulnerable adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This meant that staff had the knowledge that they needed to ensure that people were safeguarded. The service had recently made a DoLS referral to the local authority which had been made correctly.

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met.

We saw records which showed that the health and safety in the service was regularly checked.

Is the service effective?

Relatives of people who used the service told us that they were happy with the service and that it delivered care effectively. One person told us, �I have booked my place.� Another person said, �My (relative) has her ups and downs but due to the good care, love and support from all staff she bounces back and is happy here.�

We saw that the service conducted regular staff supervision and training was delivered as required. This meant that staff had the support and skills to deliver care effectively.

Is the service caring?

We saw that all staff interactions were kind and respectful. We saw staff supporting people to enjoy the good weather in the garden.

We observed staff treating people with compassion and patience when they became distressed or disorientated.

Is the service responsive?

People's choices were taken in to account and listened to. We observed staff asking people what they needed and waited for them to respond before providing further support.

People's care records showed that where concerns about their wellbeing had been identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from health care professionals, including a doctor, district nurses, mental health teams and chiropodists.

Is the service well-led?

Staff told us that they were able to speak to the manager or senior staff when they needed to and that they received regular supervision, training and support. The service had a quality assurance system and records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continually improving.

The service was supported by a manager that was hands on and who empowered the staff team to work together to deliver good care. We observed that the manager was available to staff and relatives at all times.

The manager had systems in place to ensure that they addressed any staff shortfalls or concerns and dealt with any concerns as required

Inspection carried out on 25, 26 July 2013

During a routine inspection

We spoke with fourteen people who used the service and six relatives. One person told us, "They are wonderful here, I get on so well with all the staff." One relative told us, "I have always seen people treated well, treated like individuals." We saw that people were given choices about some aspects of their care. We saw that staff did not always knock on people�s doors before entering their room and staff did not always assist people appropriately with their meals. People were not always offered activities suitable to their needs.

We saw that care plans and risk assessments were appropriate for people who used the service. Care plans were reviewed regularly or sooner if there had been changes in a person�s condition.

We saw that people were given assistance with their medications and offered as required medications if they needed them. We found that medications were not always stored or administered correctly.

We found that there was not always sufficient numbers of staff to meet people�s needs.

Staff were supported to undertake training and development. Staff told us they felt supported by management. We saw that staff had access to regular meetings and supervisions.

There was a comprehensive complaints policy in place and we saw the service responded appropriately to complaints.

Inspection carried out on 11 June 2012

During a routine inspection

During our visit to the home we spoke with ten people living in the service and two visiting relatives. One of the people using the service told us, "The care staff are good, they are very helpful and they look after you". Another person who used the service told us that they felt safe at the home and the �Carers are all polite�. One person said �When I call the bell I get help and the staff are good to me�. People told us there was entertainment each Wednesday and they had other activities in the week if they liked to take part. On relative told us that staff "Take time to understand individual people's needs and provide in depth care".