Archived: Park Farm Lodge

Is the service safe?

People did not always receive safe care.

Although improvements had been made, people at risk of developing pressure sores did not always receive appropriate care.

Records of care demonstrated that people received position changes and there were accurate records showing what people ate and drank.

Training in skin care had been provided to some staff. Some staff required further training to make sure they had the skills and knowledge to provide safe care.

Is the service responsive?

People's skin integrity was in most instances reviewed every month. This meant that people's records showed the care people needed.

People had access to nurse call bells. This meant they could ask for assistance when they needed to.

Is the service well led?

Pressure ulcer care was being closely monitored and shortfalls in care were identified and actions plans were in place to improve people's care.

We considered our inspection findings to answer the questions we always ask;

Is the service safe?

People were not always receiving safe care. There were times when people were left unsupervised for significant periods and care was not provided in a timely manner.

Staff did not have the skills and knowledge to provide people with appropriate and safe care.

Some records were not properly completed and contained gaps and omissions. This meant it was not possible to determine if people had been protected against inappropriate or unsafe care.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. We saw evidence that people's mental capacity was assessed and that best interest decisions were made. We saw that a Deprivation of Liberty application had been appropriately made.

We intend to take action to make sure that the provider takes action to address these issues.

Is the service effective?

People we spoke with said they were satisfied with the care they received.

People's needs were assessed and plans of care were in place.

Is the service caring?

People told us that care staff were caring and kind. One person said: "The girls are good". We observed that when care staff spent time with people they were friendly and treated them in a respectful manner.

People's preferences and interests were not always recorded. This meant that the information was not available to make sure people received care in the way they wanted.

Is the service responsive?

People's care was usually reassessed and evaluated every month.

The home did not provide enough interesting and stimulating activities for people to do.

In one example we found that the service had not responded quickly to one person's risk of pressure ulcers.

Is the service well led?

Park Farm Lodge has been without consistent management arrangements for over 12 months. This has meant that the supervision and management of staff and the care provided to people has lacked continuity.

The provider has identified shortfalls but the actions that have been taken have not led to a sustained improvement in the care provided to people.

People and relatives said they were pleased overall with the care provided. They said they had seen an improvement since the appointment of the new manager and were quite positive about the future. They found the manager willing to listen and to act on information to improve their relative's care.

Improvements had been made in the way hygiene and infection control was managed. We saw that a number of changes had been made to protect people against the risk of acquiring a health care associated infection.

Some improvements had been made in the staffing levels but further improvements were required. New catering and domestic staff had been employed and these were having a positive effect on the standard of care received by people who lived at the home. The home was still in the process of recruiting care and nursing staff and this meant that there were times when care was not always provided promptly.

Some improvements had been made to the care people received. Plans of care were in the process of being reviewed and updated to make sure that information corresponded with people's needs. Further improvements were needed to make sure that people always received the care they needed at the time they required.

People gave mixed views about the care. Some people were very positive about their care and told us it met their needs. One person commented: "They look after me - no complaints". Other people we spoke with were less happy and told us that they often had to wait for their care to be provided.

People's needs were assessed and plans of care were developed. Some plans were not up to date and some had not been reviewed regularly. Records outlining the delivery of care were inconsistent. This meant that it was not clear that care had been delivered to ensure the safety and welfare of people that lived at the home.

The home provided a choice of meals for people eating a normal diet. Those that needed a pureed diet did not have a choice of main meal. People that needed support sometimes had to wait a long time to have their meal.

Most areas of the home were clean although there was a malodour in many areas of the home. The home did not have an effective system in place to control the risk of the spread of infection.

There were insufficient staff available to make sure that people's care was delivered in a timely way. People had to sometimes wait to have their personal care needs met and to be supported to have their meals.

On this inspection we found that the service had made the improvements required. The provider had put in place suitable arrangements to make sure that people received their medication as prescribed.

The manager named in the report was not managing the home. Their name appears as they remain on our register.

People told us they were happy living at the home. Comments from people living at the home and from relatives included: "Definitely happy with the care", "The care staff are very nice" and "There are lots of things to do".

People were supported to have their health and personal care needs met. People had the opportunity to take part in a range of group and individual activities. People with dementia care needs had plenty of items to stimulate and engage them.

At the previous two inspections the home was not making sure people received their medication as prescribed. On this inspection we found errors in the medication administration. This meant that people were not receiving the medication they needed.

Staff were trained and supported to provide care to an appropriate standard. There were sufficient staff on duty but we have asked to the provider to consider regularly checking the level and mix of staffing.

People's views about their care were sought and the home was checking the care people received. A plan was in place to improve the quality of care.

We last visited Park Farm Lodge in June 2012. At that time we found that medication systems did not fully protect the people that lived there. The home had sent us an action plan following this visit. This recorded the action that they would take to improve upon the procedures in place for the storage, administration, recording and disposal of medication. This visit was undertaken to check on the improvements made.

We looked at medication and medication records for eight people who lived at the home. We found errors in three of the records that we looked at. This meant that people may not have had their medication as prescribed.

We spoke with the manager about our findings and were told about the new systems that had been introduced at the home to try and improve upon medication systems and practices. The manager was aware that improvements were required.