Park View

We found the following examples of good practice.

On arrival we were asked to sanitise our hands, sign in, have our temperature taken and asked if we had symptoms of, or been in contact with anyone who had symptoms of, COVID-19. We were also asked to show our vaccination record and evidence of a lateral flow device test taken that day. Face masks were available at the door should they be needed, and visitors were only admitted to the service after following these procedures.

The provider had identified the additional PPE being worn by staff had created barriers to communication with people. They had implemented effective measures to overcome and manage these barriers.

The provider supported people to maintain their links with their family and friends. People had been supported to adapt their environment to enable them to continue working remotely from their home throughout the pandemic. There were different spaces within the service they could choose to work from.

Park View is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Park View accommodates up to 10 people living with a learning disability and or physical disability in an adapted building. The care service has been developed and designed in line with the values that underpin the Registering the Right Support CQC policy and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in place. 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 the last inspection on 26 June 2017, we asked the provider to take action to make improvements regarding fire safety, and this action has been completed. Following that inspection, the service was rated Requires Improvement. At this inspection we found the service to be Good.

People were safeguarded from avoidable harm. Staff adhered to safeguarding adult’s procedures and reported any concerns to their manager and the local authority.

Staff assessed, managed and reduced risks to people’s safety at the service and in the community. There were sufficient staff on duty to meet people’s needs.

Safe medicines management was followed and people received their medicines as prescribed. Staff protected people from the risk of infection and followed procedures to prevent and control the spread of infections.

Staff completed regular refresher training to ensure their knowledge and skills stayed in line with good practice guidance. Staff shared knowledge with their colleagues to ensure any learning was shared throughout the team.

Staff supported people to eat and drink sufficient amounts to meet their needs. Staff liaised with other health and social care professionals and ensured people received effective, coordinated care in regard to any health needs.

Staff applied the principles of the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. An appropriate, well maintained environment was provided that met people’s needs.

Staff treated people with kindness, respect and compassion. They were aware of people’s communication methods and how they expressed themselves. Staff empowered people to make choices about their care. Staff respected people’s individual differences and supported them with any religious or cultural needs. Staff supported people to maintain relationships with families. People’s privacy and dignity was respected and promoted.

People received personalised care that met their needs. Assessments were undertaken to identify people’s support needs and these were regularly reviewed. Detailed care records were developed informing staff of the level of support people required and how they wanted it to be delivered. People participated in a range of activities.

A complaints process ensured any concerns raised were listened to and investigated.

The registered manager adhered to the requirements of their Care Quality Commission registration, including submitting notifications about key events that occurred. An inclusive and open culture had been established and the provider welcomed feedback from staff, relatives and health and social care professionals in order to improve service delivery. A programme of audits and checks were in place to monitor the quality of the service and improvements were made where required.

We undertook this unannounced comprehensive inspection on the 28 June 2017 to check the registered provider had met all the legal requirements. We found they had taken steps to address all of the breaches in the Regulations which we had identified in our previous inspection.

Park View is a care home that does not provide nursing. It provides support for up to 10 people, with learning disabilities and behaviour which challenges. Crescent Road where the home is situated is a quiet residential road near the sea front. On the day of the inspection there were six people living at the home and a seventh moved in during the inspection.

There was 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.

During the inspection people told us, or indicated, that they enjoyed living at the home, and staff we spoke with and observed understood people's needs and preferences well. Staff were able to describe to us how people needed to be supported to ensure they were cared for safely, and the rationale behind this.

People were not always safe. Staff understood their role and responsibilities to keep people safe from harm. Risks were assessed and plans put in place to keep people safe. There were enough staff to safely provide care and support to people. However fire safety equipment had been highlighted for several months as an issue and had not been repaired.

At our last inspection we found a failure to ensure that equipment used by the provider was safe to use; failure to control the risks associated with prevention of the spread of infection by not keeping clean and monitoring PEG areas, suction machines and masks and spacers for inhalers. At this inspection we found that records contained information associated with the safe use of equipment to help support people with their care, food and nutrition.

Care records contained risk assessments to protect people from identified risks and help to keep them safe. These gave information for staff on the identified risk and guidance on reduction measures. There were also risk assessments for the building and contingency plans were in place to help keep people safe in the event of an unforeseen emergency such as fire or flood.

Thorough recruitment checks were carried out to check staff were suitable to work with people. Staffing levels were maintained at a level to meet people’s needs.

At our last inspection we found that people’s medicines were not managed safely. At this inspection we found changes had been made and staff had undertaken medicines training to ensure their understanding. People were supported to take their medicines as prescribed by their GP. Records showed that medicines were obtained, stored, administered and disposed of safely.

We saw that people had choice and control over their lives and that staff responded to them expressing choice in a positive and supportive manner.

The service was effective. Arrangements were made for people to see their GP and other healthcare professionals when required. People’s healthcare needs were met and staff worked with health and social care professionals to access relevant services. The service was compliant with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People received a service that was caring. They were cared for and supported by staff who knew them extremely well. Staff treated people with dignity and respect. People’s views were actively sought and they were involved in making decisions about their care and support. Information was provided in ways that was easy to understand. People were supported to maintain relationships with family and friends.

The service was responsive to people’s needs. People received person centred care and support. People were encouraged to participate in employment and leisure activities. People were encouraged to make their views known and the service responded by making changes. Transitions for people moving from the service were well planned. Staff had worked to ensure people had access to healthcare services.

At the last inspection we found that systems were not effective in monitoring the care provided at the service. At this inspection we found that although the quality audits by the provider had not been carried out as regularly as the provider would have liked there had been an improvement as the manager had carried out their regular monitoring. However this monitoring had not highlighted the issues with fire safety equipment.

People benefitted from a service that was well led. The registered manager had an open, honest and transparent management style. The manager and provider had systems in place to check on the quality of service people received however they had not ensured shortfalls identified in fire safety were acted upon.

We found two breaches of the Health and Social Care Act 2008 (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.

Park View is a care home that does not provide nursing. It provides support for up to 10 people, with learning disabilities and behaviour which challenges. Crescent Road where the home is situated is a quiet residential road near the sea front.

A registered manager was in place. 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.

Risks associated with people’s care had been assessed and plans had been developed to ensure that staff met people’s needs consistently and reduced such risks. However risks existed regarding the safety of medicines and the control of infection was not always managed regarding the use of equipment and personal care

Medicines were not always managed safely and there was a safeguarding investigation in progress around medicines. The provider has kept us informed about the ongoing issues and action they are taking.

During the inspection people told us, or indicated that they enjoyed living at the home, and staff we spoke with and observed understood people's needs and preferences well. Staff were able to describe to us how people needed to be supported to ensure they were cared for safely, and the rationale behind this.

Whilst staff knew people well, and stated people had been involved it was not possible to see from their plans of care how staff had involved people in looking at their support needs and risks associated with those needs. Plans of care were not always clearly personalised

Observation demonstrated people’s consent was sought before staff provided support. Staff and the manager demonstrated a good understanding of the Mental Capacity Act 2005.

We found that staff received a good level of training; the provider's own records evidenced this, as did our observations and the staff we spoke with.

Staff demonstrated a good understanding of safeguarding people at risk. They were confident any concerns raised would be acted upon by management and knew what action to take if they were not.

Recruitment checks were carried out however, not all the information was available at the time of inspection as it was kept at the provider’s office. The provider has told us since the inspection that references and copies of police checks will be kept at the home.

The provider ensured there were enough staff on duty to meet people’s needs. Staff received a thorough induction when they first started work which helped them to understand their roles and responsibilities.

People and their relatives knew how to make a complaint and these were managed in line with the provider’s policy. Systems were in place to gather people’s views and assess and monitor the quality of the service. However, these systems had not identified the issues we had with records, nor identified concerns we had in other areas.

We found breaches in two of the Health and Social Care Act 2008 (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.

We also used this inspection to answer our five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people who used the service, their relatives and the staff told us.

Is the service safe?

People's health and care needs were assessed before they moved into the home. We saw that care plans contained clear information about people's support needs. We also found the risks associated with people's care and treatment had been assessed and there was clear information on how any risks could be minimised.

The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Although no DoLS applications had been made, the manager was able to describe the circumstances when an application should be made and knew how to submit one.

We found that the skill mix of staff who worked at the home was sufficient to meet people's needs at all times.

Is the service effective?

All people had an individual care plan which set out their care needs. People and relatives we spoke with told us they were satisfied with the care and support given by staff at Park View. One person said, "I am quite happy here'. A relative told us 'The staff listen to what I say". We observed staff supported people effectively.

Is the service caring?

We saw that people were supported by kind and attentive staff. Care workers showed patience and gave encouragement when supporting people. They were aware of people's needs and the preferences of people they cared for in how people wanted care to be delivered.

Relatives of people who used the service told us staff were kind and caring. Staff told us that they always respected people's decisions and wanted to provide the best possible support for people.

Is the service responsive?

People's care plans included information about their needs and preferences. People we spoke with told us they were listened to and staff respected their wishes.

We saw that care plans were reviewed regularly and staff at Park View responded to changes in people's needs or circumstances.

We saw that people were able to participate in a range of activities both in the home and in the local community.

Staff told us that they encouraged and supported people to participate in activities to promote and maintain their well-being.

Relatives we spoke with told us that they had regular contact with the home and they could speak to the manager or staff at any time. They said they were kept informed about any issues which affected their relatives.

Is the service well led?

The provider organisation employed a quality manager who carried out twice yearly audits of the service provided at Park View. Annual surveys were sent out to stakeholders including, staff residents and families.

All staff received supervision every eight weeks. Staff performance issues were discussed and additional staff training was identified as necessary.

Staff meetings took place each month and minutes of these meetings were kept. Staff we spoke with confirmed this and said the staff meetings enabled them to discuss issues openly with the manager and the rest of the staff team.