Background to this inspection
Updated
31 August 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
We carried out an inspection of Park View on 18 and 19 July 2018. This inspection was unannounced and carried out by two inspectors, one pharmacist specialist and one expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection we reviewed relevant information that we held about the service. This included the previous inspection report, and notifications we had received. Statutory notifications are pieces of information about important events which took place at the service, such as safeguarding incidents, which the provider is required to send to us by law. We contacted other health and social care professionals for their feedback, including Healthwatch. The Local Authority, who have a commissioning role, sent us a copy of their most recent quality assurance monitoring report. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection we spoke to 20 people who used the service and seven relatives. We spoke to 15 staff members, including the acting manager, the regional manager, the chef, the activities co-ordinator, an administrator and care staff. We also spoke to three health and social care professionals. We reviewed documents and records that related to people’s care and the management of the service, including 15 care plans, 15 staff files, the staff rota, Medicine Administration Records (MAR), service audits and health and safety policies and procedures and records.
We also undertook general observations of people in each community and used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
After the inspection we received further documents including the resident’s handbook and an action plan addressing the recommendations we made during this inspection.
Updated
31 August 2018
We carried out an unannounced inspection of this service on 18 and 19 July 2018. Park View is a care home providing accommodation and nursing care for 108 adults including younger adults who may have a diagnosis of dementia. At the time of our inspection 108 people were living in the service.
People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. This service provides personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service did not have a registered manager in post. At the time of the inspection there had not been a registered manager in post for 100 days. 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 on 18, 19, 21 and 28 July 2017, the service was rated 'Requires Improvement'. We identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider did not always have plans in place for managing risks people faced. The provider did not always manage and administer medicines safely, and guidance for how to administer medicines covertly was not always clear and some decision forms were incomplete. There was not enough suitably qualified, competent, skilled and experienced staff in place to meet the requirements of people using the service. The provider did not ensure staff received appropriate support, training, professional development and supervision necessary to enable them to carry out their duties. Quality assurance systems and audits had not operated to assess and improve the quality and safety of the service provided.
At this inspection we found that these breaches had been addressed.
People using the service and their relatives said the service provided safe care and treatment. The service managed medicines safely. However, not all ‘decision to administer’ forms were updated to match people’s changing prescriptions and not all medicines were disposed of appropriately. The acting manager addressed these concerns following the inspection. There were sufficient numbers of suitable staff employed by the service. Staff had been recruited safely with appropriate checks on their backgrounds completed. People were protected by the prevention and control of infection. There were robust procedures in place to protect people from harm and staff were clear on how to recognise and report abuse. The provider assessed and managed risks to people in a way that considered their individual needs.
Staff understood the Mental Capacity Act 2005 (MCA). MCA is law protecting people who are unable to make decisions for themselves and where people were not able to do this, the appropriate authorisation procedures had been completed. These are referred to as the Deprivation of Liberty Safeguards (DoLS).
Staff undertook training and received regular supervision to help support them to provide effective care. People were encouraged to live a healthy lifestyle and received holistic support from various health and social care professionals.
People and their relatives told us staff supported them or their relative with dignity and respect. They ensured people’s privacy was maintained particularly when being supported with their personal care needs. People were supported to be as independent as possible and staff supported them in the least restrictive way possible. People and their relatives felt involved in the running of the service and could have an input into the care provided.
Each person had an individual care plan. However, these care plans were not always up to date and did not always reflect people’s support needs. The acting manager advised the care plans were being reviewed. The service did not always have enough meaningful activities in place to ensure people were engaged. The acting manager advised they were addressing this. People and their relatives felt comfortable raising any issues they might have about the service and there were arrangements in place to deal with people’s complaints. The service supported people with their end of life wishes.
The service and provider demonstrated an open and transparent culture. They routinely gathered feedback from people, relatives and staff. This feedback alongside the acting manager’s audits and quality checks were used to continually assess, monitor and improve the safety and quality of the service. Staff felt valued and supported by the acting manager who was approachable and knowledgeable.