Royal Park

Updated 17 November 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector and a specialist advisor. The specialist advisor was a nurse.

Service and service type

Royal Park is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Royal Park is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since our last inspection, including notifications the provider had sent to us. We also gathered feedback from the local authority and other health professionals who had attended the home.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with four people living in the home. We looked at the care records for seven people. We also spoke with the registered manager, clinical lead, nursing and care staff. We checked that the care they received matched the information in their records. We also observed the care people received in communal areas. We looked at records relating to the management of the service, including audits carried out within the home.

Updated 17 November 2022

About the service

Royal Park is a care home that provides both short and long-term placements for up to 22 people with needs related to neurological conditions, a brain or spinal injury as well as artificial ventilation and tracheostomies. At the time of the inspection 22 people were living at the home.

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

People did not always receive safe care as care plans in place were not always followed. Care plans in relation to emotional distress did not always have the detailed guidance needed for staff to follow. When people had individual risk, these were not always managed in a safe way to ensure people received the support they needed.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. The systems in place were not also effective in identifying all areas of improvements. Systems were often disorganised, and it was difficult to find information about people as this was not stored or recorded together. Concerns had been identified with the systems however insufficient action had been taken.

There were systems in place to manage medicines, these were followed, and people received medicines when needed. Infection control procedures were followed and implemented. People were protected from potential abuse and when needed action was taken. There were enough suitable training and recruited staff to support people when needed.

Staff felt supported and listened to and people had the opportunity to be involved with their care and raise any concerns. There was evidence lessons were learnt when things went wrong. People had assessments in place which identified their needs so that care could be provided. People enjoyed the food and were offered a choice; people’s dietary needs were considered. People had access to health professionals when needed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 25 May 2019)

Why we inspected

We received concerns in relation to tracheostomy and percutaneous endoscopic gastrostomy (PEG) care. We also received concerns that related to urine infections. As a result, we undertook a focused inspection to review the key questions of safe, effective well-led only.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

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

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Royal Park on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to hoe people’s safety was monitored, how people were supported with capacity and consent and the systems that governed the home.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.