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Parklands Court Care Home Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 26 March 2019

During a routine inspection

About the service: Parklands Court provides accommodation and personal care with nursing for up to 163 older people who may have dementia and nursing needs. The service also offers palliative, rehabilitative and respite care. 103 people lived at the service on the first day of our inspection.

Parklands Court is purpose built and consists of six separate, single storey buildings: Collins, Samuel, Harrison, Marlborough, Elmore and Clarendon. The Clarendon unit was closed at the time our visit.

People’s experience of using this service: There were occasions where we saw there was not always enough staff in some units at lunch times, and this did have some impact on the quality of meal provision. The registered manager took some action to address this during our inspection. People told us they were happy with how they received their medicines. We found some areas where there was scope to make medicines management safer and the registered manager took immediate action during our inspection to address these issues. There was also a need to address some outstanding actions identified by infection control audits within the refurbishment of the service.

People looked comfortable and relaxed with staff and their relatives told us they were safe. Staff told us how they kept people safe and minimised risks.

People were supported by staff who were caring and expressed empathy and compassion towards people who lived at Parklands Court. We saw staff respected people and promoted their privacy, dignity and independence.

People received effective person-centred care and support based on their individual needs and preferences. Staff were knowledgeable about people’s needs and preferences and we staff fostered good relationships with people.

People were supported by care staff who had a range of skills and knowledge to meet their needs. Staff understood their role, felt confident and well supported. Formal staff supervision had now commenced. People's health was supported as staff worked with other health care providers to ensure their health needs were met.

People were supported to have choices, and the provider’s policies supported this practice. There were some occasions where the provider’s policies were not consistently followed to ensure decisions about people’s care were in their best interests.

People's care plans reflected people’s needs and preferences and staff and the registered manager could explain any recent changes to people’s care. We saw staff responded to people’s needs effectively and their preferences were respected.

People and their representatives knew how to complain. Relatives and staff knew how to identify and respond if people were unhappy with the service. People were able to communicate how they felt to staff, and said staff were approachable and listened to what they had to say. Relatives told us when they had raised concerns these had been addressed appropriately.

Most people, relatives and staff gave a positive picture as to the quality of care people received and said the registered manager and other staff were approachable.

Quality monitoring systems were in place, and the provider had made improvements since our previous inspection, although these improvements still needed to be embedded. The registered manager and provider demonstrated they were responding to findings from the quality monitoring system so that lessons were learnt and outcomes for people improved.

Rating at last inspection: The rating for the service at our last inspection was ‘requires improvement’ (Published on 28 August 2018). This is the second time this service has been rated requires improvement with the current provider.

Why we inspected: This was a planned comprehensive inspection that was due based on our scheduling targets. We had issued a warning notice to the provider following our previous inspection regarding breaches we identified in respect of governance of the service and we found the provider had ad

Inspection carried out on 15 May 2018

During a routine inspection

This unannounced inspection took place on 15 May 2018 with a return announced visit on 17 May 2018. There has been a change of ownership and this will be Parklands Court Care Home’s first inspection since it was registered under the new provider, Advinia Care Homes Limited, in November 2017.

Parklands Court 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.

Parklands Court is purpose built and consists of six separate, single storey buildings: Collins, Samuel, Harrison, Marlborough, Elmore and Clarendon. The Clarendon unit was closed at the time our visit. The service is registered to accommodate up to 163 people providing nursing care to older people living with dementia and people who require rehabilitation and palliative care. At the time of our inspection there were 104 people using the service. Parklands Court is currently subject to a restriction on admissions imposed by the local authority and clinical commissioning group. This was imposed prior the registration of the new provider but has remained in place.

The home manager was not yet registered with CQC but told us it was their intention to apply. 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 recognised the service is undergoing a major transformation. The governance systems had only just started to be implemented and had not been consistently effective at ensuring good working practices were constant across all the units. They were not always effective in ensuring all people received a good quality of service. The manager had worked closely with partner agencies to monitor and improve the quality of the service and where shortfalls had been identified, they were investigated thoroughly and appropriate action plans put into place to reduce risk of reoccurrences. People who used the service, most relatives and staff were confident in the new leadership of the service.

Full information about CQC's regulatory response to issues and concerns found during inspections are added to this report after any representations and appeals have been concluded.

Risks to people had been assessed and processes were in place to reduce the risk of avoidable harm. However, staff members’ working practices were not consistent across the service because we saw unsafe techniques were used to move people. Where risks were identified, we found that staff members were not always provided with the relevant information in people’s risk assessments to keep people safe. Risks associated with peoples’ nutrition were not always managed effectively. People told us they received their medicines appropriately, but some people did not receive timely pain relief because the staff had not identified that people were in discomfort.

People told us they felt safe and staff understood their responsibility to raise concerns regarding potential abuse. There were processes in place to ensure the premises and equipment was checked to maintain people’s safety. People were protected from the risk of infection. There were systems in place to investigate incidents and share learning when things went wrong.

There were not consistently sufficient numbers of staff employed to meet people's needs across the service. Employment checks had been undertaken on staff to ensure they were suitable for their roles. Staff received limited supervision and appraisals, but told us they felt supported by the management team to carry out their roles. Staff members were aware of the provider's policies to pre