Archived: Parkview Care Home

Parkview Care Home is registered to provide nursing care to older people. The home can accommodate up to 24 people. At the time of our inspection 19 people were living at the home.

The home had a registered manager. 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 breached the regulations relating to person-centred care. Risk assessments had not been personalised to the needs of each person and some were out of date. Some care plans were not up to date and others lacked personalised information to ensure people received appropriate care.

Quality assurance systems were not effective in proactively identifying issues we found with care planning and risk assessments.

You can see what action we have asked the provider to take at the back of the full version of this report.

The provider had not always followed the requirements of the Mental Capacity Act (MCA) 2005. A decision to provide a specialist bed for one person lacking capacity had been made without a MCA assessment and best interest decision having been made first. We have made a recommendation about this.

Deprivation of Liberty Safeguards (DoLS) were not in place or applied for all people who were unable to consent to their placement in the home. The registered manager advised us this was following advice from the local authority responsible for processing DoLS applications.

Care workers supported people to make as many of their own choices and decisions as possible.

People and care workers felt there were enough care workers on duty to meet people’s needs. Staffing levels were monitored and staffing levels had increased as a result of the most recent review of staffing levels.

People said they were happy with both their care and the care workers who provided it. They said care workers were kind and caring and treated them with respect.

Care workers demonstrated a good understanding of safeguarding adults and whistle blowing, including how to report concerns. All of the care workers we spoke with said they would have no hesitation raising concerns to keep people safe.

Medicines records we viewed supported the safe administration of medicines. Medicines administration records (MARs) were accurate and medicines were stored securely.

Regular health and safety checks were carried out to help keep the home safe, such as checks of fire safety, water and the gas supply. Information was available about people’s care and support needs in an emergency situation.

Incidents and accident logs were kept which detailed investigations and action taken to help prevent accidents reoccurring.

Care workers told us they received good support. Records were available to show care workers had regular one to one supervisions and appraisals. Training records conformed essential training was up to date for care workers.

People were happy with the meals provided at the home. We observed during the lunch time there were not enough staff available in the dining room to provide support in a timely manner.

Care records showed people had regular input from external health professionals in line with their needs, such as GPs and community nurses.

People’s needs had been assessed and care plans developed. Some care records provided care workers with information about people’s preferences, such as their likes and dislikes.

Activities were available for people to participate in if they chose to, such as games, manicures and one to one time with care workers.

People knew how to complain but said they did not have any concerns about their care. Records showed previous complaints had been thoroughly investigated and resolved.

People said the registered manager was approachable and the home had a good atmosphere.

An individual daily record of the care people had received was not kept for people using the service.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five 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?

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Suitable policies and procedures were in place and staff had been trained to understand their responsibilities under the DoLS Codes of Practice.

Care records and our observation of staff provided evidence of good practice in applying the least restrictive options to promote and maintain an individual's independence.

People told us they felt safe and we saw that there were systems were in place to make sure staff learned from events such as accidents and incidents, and complaints and concerns,. This reduced the risks to people and helped the service to continually improve.

Is the service effective?

The service took into account people's care needs when making decisions about the numbers of staff and their qualifications, skills and experience required to cover the rotas.

We looked at a sample of people's care plans and saw evidence to show where possible, people had been involved in developing their care records. This meant they received care and treatment in a way they preferred.

Is the service caring?

People's care needs were assessed by the staff along with people who used the service and/or their family members or representative. People were involved in developing their own care records. We saw that they reflected their current needs and we saw they were up to date.

We saw people being supported by staff who demonstrated empathy and listened to what the person wanted.

People's preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

People who used the service told us they were happy living at the home.

Is the service responsive?

People who used the service were provided with the opportunity to participate in activities which interested them. People's choices were taken in to account and listened to.

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 and social care professionals, including doctors, district nurses, social workers and mental health professionals.

People we spoke with knew how to make a complaint if they were unhappy. The service worked well with other agencies and services to make sure people received care they needed.

The registered manager was able to access all the information we asked for on the day of our visit in order for us to make our judgements.

Is the service well-led?

Parkview Care Home had a statement of purpose that covered resident's rights, privacy, dignity, independence, choice and complaints.

Staff told us they were clear about their roles and responsibilities. We reviewed the minutes from staff meetings which showed that the management team had consulted with staff before implementing changes in the service. This helped to ensure that people were provided with a good quality service.

The service had an effective quality assurance system and records reviewed by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

The assessment, care planning and review systems in place promoted peoples wellbeing and safety.

The provider had suitable arrangements to ensure that medication was safely managed at Parkview.

The provider had taken steps to provide care in an environment that was adequately maintained.

We saw that suitable staff were employed because a robust recruitment and selection process had been followed.

We visited the home on the 6 December 2012 and found improvements in fire safety arrangements at the home, we found improvements in the way controlled drugs were managed and found the home now had a registered manager.

People living at the service told us they were well cared for. One person said, 'They look after me and I always get my tablets'.

One visitor told us they were completely satisfied with the level of care and support provided by staff. They told us staff always ensured that their relatives health needs were met and this included contacting the GP and ensuring prescribed medications were given.

Another visitor said they had noticed an improvement in their relative's health since they had moved into the home. They told us, 'they're brill'they do a good job. I'm very happy, X looks so much better'.