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Inspection carried out on 4 December 2018

During a routine inspection

At the last inspection on 24 and 25 October and 2 November 2017 we found two breaches of regulation. People’s risk levels had not always been sufficiently assessed to fully minimise potential impact on people, quality monitoring systems had not always identified shortfalls in quality and risk management and robust staff recruitment procedures had not always been followed before staff worked with people.

We asked the provider to complete an action plan, which we received, to show us what they would do and by when, to meet Regulation 17 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and to improve the overall rating of the service.

During this inspection, on 4 and 5 December 2018, we found people’s risks were assessed and reassessed following changes in health and abilities. Staff started work after appropriate recruitment checks had been completed. Quality monitoring processes identified areas for improvement, which were being planned and completed. The breaches in regulation had been met.

The overall rating for the service has improved to ‘Good’.

About the service:

• Park View is a newly built, residential care home, which opened in 2016. It can provide personal and nursing care to 102 people. At the time of the inspection areas of the home were still being commissioned and 69 people in total received care. The home catered predominantly for people who were 65 years and over. Staff supported a wide range of needs which included people who required very little support, to people who were fully dependent and required nursing care. It also supported people who lived with to dementia.

People’s experience of using this service:

• The building and its adaptions helped people with diverse needs live safely and comfortably. The provider had identified that improvements were needed to the areas where people who lived with dementia were supported. We have made a recommendation about seeking current best practice in doing this.

• Risks to people’s health were identified, assessed and action taken to reduce these, or where possible, remove risk altogether.

• The home’s policies and procedures, staff knowledge and practices supported a zero tolerance of abuse or discrimination.

• Some people commented, there needed to be more staff, however, we observed people receiving timely support and call bells were answered without delay.

• Necessary recruitment checks were completed, before, staff started work at the home in order to protect people from those who may not be suitable to care for them. On-going staff recruitment ensured staff with the right skills and knowledge were employed.

• People’s medicines were managed safely and people received help to take these.

• Planned maintenance, servicing and cleaning arrangements kept the environment and equipment safe and clean.

• Infection control arrangements reduced the risk of infection.

• The building was secured but technology allowed people and designated relatives to come and go as they chose.

• People’s needs were assessed before they moved in and re-assessed at intervals, to ensure their care and treatment remained appropriate.

• Staff received training and support to be able to manage people’s needs, preferences and expectations.

• People had good access to health and social care professionals when needed.

• People had a choice in what they ate and drank and their nutritional wellbeing was supported.

• People’s care was planned with their involvement and, where appropriate, with the involvement of those who represented them. Care records were kept up to date so staff and visiting professionals had the right information about people’s needs.

• Care was delivered in a personalised way, respecting individual choice and preference.

• People had access to supported activities and opportunities to socialise but some felt there was not enough. Action had been taken to support more personalised activities.

• People were supported

Inspection carried out on 24 October 2017

During a routine inspection

This inspection took place on the 24, 25 October and the 2 November 2017 and was unannounced. This was the first inspection of the service.

Park View Gloucester is a care home for up to 102 people, at the time of our inspection there were 39 people staying there. Accommodation is on four floors, the second floor was not in use at the time of our inspection visits. The first floor provided accommodation for people living with dementia.

Park View Gloucester had 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.

It was evident through our conversations with the registered manager and director they were motivated to continually improve the service and took immediate action to address the shortfalls we found. A range of audits were carried out to monitor the quality and risks in the home. However; these had not identified the shortfalls we found in relation to staff recruitment and delays in assessing changes to people’s risks prior to our inspection.

Safe recruitment procedures were not always followed before staff were appointed to work at Park View Gloucester. Changes to people’s risks were not always promptly assessed to ensure their risk management would remain effective. Improvements were needed to ensure when the provider’s nurses were undertaking wound treatments their wound management systems would be implemented to enable monitoring of treatment.

During this inspection we found the provider was taking action to ensure people living with dementia would always be supported effectively. This included completing the assessment of people’s capacity to consent to care and support. Training and guidance were being provided to ensure staff could plan and implement appropriate support for people who could become agitated. The environment was being reviewed to ensure it met the needs of everyone in the home.

People were treated with respect and kindness. Their privacy and dignity was upheld and they were supported to maintain their independence. People received personalised care and had opportunities to take part in a variety of suitable activities. There were arrangements in place to respond to concerns or complaints from people using the service and their representatives. Care was provided for people at the end of their life.

People were protected from harm and abuse through the knowledge of staff and management. Sufficient staffing levels were maintained and staff were supported through training and meetings to maintain their skills and knowledge to care for people. The registered manager was accessible to people using the service and their representatives. A survey had been completed to gain the views of people about the service provided.

We found breaches of The Health and Social Care Act (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.