This comprehensive inspection took place on 30 July, 1, 3, 6 and 16 August 2018. On 30 July and 6 August 2018, the inspection visits were unannounced. On 1 August 2018, we made telephone calls to people who used the service and their relatives. On 3 August 2018, we made telephone calls to staff. On 16 August 2018, the inspection visit was announced.
Park Lodge operates both a care home and domiciliary care service under the registration of this location with the Care Quality Commission (CQC). The care home provides accommodation for persons who require nursing or personal care for up to 40, primarily, older people. The domiciliary care service offers care to people in their own homes. At the time of our inspection, 38 people were using the care home service and 13 were using the domiciliary care service.
Park Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
This service is also a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults.
Park Lodge was last inspected on 10 November 2015 and the service was rated as Good. On this inspection, the service has been rated as Requires Improvement. Providers should be aiming to achieve and sustain a rating of 'Good' or 'Outstanding'. Good care is the minimum that people receiving services should expect and deserve to receive; we found systems in place to ensure improvements were made and sustained were not effective. This is the first time the service has been rated Requires Improvement.
There was a registered manager in post. A registered manager is a person who has registered with CQC 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.
There were systems in place to monitor and improve the quality of the service provided. However, these were not fully effective and had failed to identify the concerns we found with regards to several records in the service.
We found some care plans lacked person-centred detail and contained inconsistent or contradictory information. This could lead to people’s care needs being missed or overlooked.
We identified some improvements were needed to the records of medicines administration. The registered manager acted to ensure the concerns were addressed by the end of the inspection.
Overall, we saw risks were managed, and staff understood how to ensure these risks were minimised. However, records of risk management needed to be strengthened.
The registered manager and staff we spoke with had some understanding of the principles of the Mental Capacity Act (MCA) 2005 and their responsibilities when working in accordance with the legislation. However, where people lacked capacity to make decisions about aspects of their care, records did not show how decisions had been made in people’s best interests.
We recommend the provider reviews the records of capacity assessments and decisions made in people’s best interests to ensure people’s rights are fully upheld.
Staff were seen to be kind and caring in their interactions with people, but some people told us they did not always find all staff to be caring in their approach. Staff showed a good knowledge of the people they supported, and understood how to maintain their privacy and dignity.
People and staff told us the service was safe. Staff could tell us how they would report and recognise signs of abuse and had received training in safeguarding adults. Recruitment was managed safely.
There were enough staff to provide support and ensure people’s needs were met. Staff received supervision, appraisal and training to enable them to carry out their role. Staff spoke highly of the support and training they received.
People received support from health care professionals where they needed this to keep well. People spoke highly of the food at the service and their dietary needs were recognised and met.
There were effective systems in place for responding to people’s concerns and complaints. People told us they knew how to raise concerns if they had any.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014. You can see the action we have told the provider to take at the end of this report.