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Gorton Parks Care Home Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 5 November 2019

During an inspection to make sure that the improvements required had been made

About the service:

Gorton Parks is a purpose-built ‘care home’, situated within a quiet residential area of Manchester, with good links into Manchester city centre.

Gorton Parks has five separate ‘units’; three units are dedicated to nursing or residential care. One and a half units are dedicated to intermediate care, these provide beds to people who are being discharged from hospital and half of one unit is dedicated solely to nursing care. The service can accommodate up to 148 people. At the time of the inspection, there were 139 people living at the home.

People’s experience of using this service and what we found:

At this targeted inspection we found that there were safe, comprehensive and robust systems in place to ensure people received a safe level of care.

People received sufficient provisions and we were informed by chef manager as well as laundry and domestic staff that the ordering and supply system in place worked well.

People were living in a safe, comfortable and clean environment. Environmental risk assessments and management procedures meant that people’s level of safety was a priority and never compromised.

We received positive comments about staffing levels at Gorton Parks. A recent recruitment drive meant that the use of agency staff had reduced, and the home was generally being supported by regular Gorton Parks staff.

We checked that there were sufficient cleaning products in place and infection prevention control procedures were complied with. The home was clean, hygienic and odour free and staff told us that effective cleaning schedules were completed on a daily basis.

An on-line digital platform ensured that all accident and incidents were recorded, monitored and analysed. Local and regional managers maintained a good level of insight in relation to all accidents and incidents and the level of risk was safely managed.

Rating at last inspection:

The service was rated ‘requires improvement’ at the last inspection (report published 23 July 2019). We found breaches of regulation in relation to safe care and treatment, good governance and staffing (training). The registered provider was requested to submit an action plan which identified how they would follow up on the concerns we identified.

Why we inspected:

The inspection was prompted due to concerns received about the provision of care people received. We undertook this targeted inspection to ensure that the service was meeting legal requirements. To do this we examined risks relating to systems and processes, areas of risk management and safety monitoring and provisions that were in place to ensure people were living in a safe and well-maintained environment.

A decision was made for us to inspect and examine those risks. This targeted inspection only focused on specific concerns and did not cover all key lines of enquiry, as a result the ratings for this service have not been changed. The ratings for this service will be reviewed as part of our next comprehensive inspection.

We found no evidence during this targeted inspection that people were at risk of additional harm from the concerns we had received since we last inspected.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Gorton Parks on our website at www.cqc.org.uk.

Follow up:

We will continue to monitor intelligence we receive about the service until we return as per inspection programme. If any concerning information is received, we may inspect sooner.

Inspection carried out on 10 June 2019

During a routine inspection

About the service

Gorton Parks is registered to accommodate up to 148 people across five separate units. At the time of our inspection there were 133 people living at the service.

Three units specialise in either nursing or residential care (Sunnybrow, Abbey Hey and Melland). Delamere and part of Debdale are ‘intermediate’ care beds which provide reablement services for people discharged from hospital. The care staff were employed by Advinia, with the NHS providing the nurses, physiotherapists and occupational therapists. The other half of Debdale is a nursing unit run by Advinia.

Each unit has a lounge, dining area, a conservatory, and a kitchenette. All bedrooms are single with no ensuite facilities. Accessible toilets and bathrooms are located near to bedrooms and living rooms.

People’s experience of using this service and what we found

People living in Abbey Hey did not always receive their medicines as prescribed. Written guidance for medicines not routinely administered were not in place for the NHS units and did not explain when the medicine should be administered. Medicines records were not always fully completed.

Staff received training to support them in their role and were positive about the training they had. However, staff supporting people living with dementia had not completed training in dementia awareness or managing challenging behaviours.

The quality management system was better organised than at our last inspection, with audits being completed as scheduled. However, the medicines audits for Abbey Hey had consistently shown 80% compliance until June 2019 when the audit was 64%. Audits had not picked up the other medicines issues we identified. Training audits had not identified the gaps in training for staff working with people living with dementia.

Incidents and accidents were recorded and reviewed by the registered and clinical services managers. We have made a recommendation about ensuring all incidents are reported.

People and relatives said they felt safe living at Gorton Parks and were positive about the care staff. Staff knew people and their needs and explained how they maintained people’s privacy and independence.

There were sufficient staff on duty to meet people’s assessed needs, although they were seen to be busy. An activity coordinator team arranged activities for people or engaged in individual chats with people. Two of the five coordinators had started work on the first day of our inspection. We did not observe staff having the time to engage people in activities on the households as they were busy supporting people.

Staff were positive about working at Gorton Parks. They felt supported and that the management team were approachable and would listen to their concerns or ideas.

The home was visibly clean, however there was an odour in the lounge area of Abbey Hey. Equipment was checked, maintained and serviced in line with regulations and guidelines.

Risk assessments and care plans were in place and reflected people’s needs. The majority of care plans had been re-written on Advinia paperwork. The remaining care plans were on track to be transferred. People and their relatives had been involved in agreeing their care plans.

People’s end of life wishes were recorded.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported to maintain their health. Referrals were made to medical professionals appropriately.

People received support to maintain their food and fluid intake. People’s weights were monitored, and fortified foods offered to those at risk of losing weight.

People’s cultural needs were recorded and were being met. A range of culturally appropriate meals were available. People’s communication needs were recorded, and staff knew how they communicated and made decisions.

The servic

Inspection carried out on 20 November 2018

During a routine inspection

This inspection took place on the 20, 21 and 22 November 2018, with the first day being unannounced. This was the first inspection of Gorton Parks Care Home since it had been bought by Advinia Care Homes Limited in March 2018. The staff teams for each house remained the same. A new registered manager joined the home in July 2018. One clinical services manager (CSM) remained the same, with a second CSM being appointed in November 2018. Changes had been made at the provider’s area manager level and above. The home, under its previous ownership (Bupa), was inspected in July 2017. References throughout this report to 'the last inspection' concern this inspection.

Gorton Parks 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.

Gorton Parks is registered to accommodate up to 148 people across five separate houses. Three houses specialise in either nursing or residential care (Sunnybrow, Abbey Hey and Melland). Delamere and part of Debdale are ‘intermediate’ care beds which provide re-ablement services for people discharged from hospital. The care staff in these houses are employed by Advinia, with the NHS providing the nurses, physiotherapists and occupational therapists. The other half of Debdale is a nursing unit run by Advinia.

Each house has a lounge, dining area, a conservatory, and a kitchenette. All bedrooms are single with no ensuite facilities. Accessible toilets and bathrooms are located near to bedrooms and living rooms.

There was a registered manager at Gorton Parks. 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 our last inspection in July 2017 we identified three breaches of Regulations because medicines were not safely managed, activities were not organised to stimulate people, there were insufficient staff to meet people’s needs at meal times and quality assurance audits had not been sufficiently robust.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe, effective, caring, responsive and well led to at least good. At this inspection we found some improvements had been made.

We found improvements had been made and medicines were now managed safely and four activity co-coordinators had been recruited and people were positive about the activities now being organised on each household.

However there continued to be a breach in regulations as staffing levels on Sunnybrow household, especially during mealtimes due to the number of people who needed support to eat their food, were insufficient. Feedback about staffing levels for the other units was positive.

We also identified a breach in regulations because two care plans on Sunnybrow were not reflective of people’s current needs. The care plans we viewed on the other units reflected people’s identified needs and were reviewed each month. Risks had been identified and steps taken to reduce the likelihood of the identified risk occurring. Where people might have behaviour that challenges, care plans gave details of potential triggers and behaviours.

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

Improvements had been made to the quality assurance system, although these were still bedding in at the time of our inspection. Actions identified from the audits were completed for the specific care plan or medicines plan reviewed but were not applied across all plans on the household. The home planned to increase the number of care plans