Archived: Parc Vro Residential Home

Parc Vro provides accommodation with personal care for up to 15 people. There were 14 people using the service at the time of our inspection. The service is a detached two storey building with an enclosed garden.

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

At the previous inspection we found risks had not been appropriately assessed or managed which meant people were unnecessarily exposed to risk of harm and that some aspects of governance systems were not effective At this inspection we found improvements had been made and risks were appropriately managed and new systems had been implemented to provide a better oversight of the service.

The provider and manager had implemented new electronic systems that covered areas such as care plans, risk assessments and governance systems. Care plans informed staff on how to support people, but further direction would be beneficial. For example, when stating staff would provide ‘reassurance’, it did not direct or guide staff how to provide this. This was discussed with the manager and care coordinator who stated they could see the benefit of expansion. This meant staff who did not know people well would not understand how to meet people’s emotional needs. We made a recommendation about this in the report.

At the previous inspection a new provider and new manager had recently commenced.. They had now been in post for five months and had submitted their application to be registered with the Care Quality Commission.

People, relatives and staff were all positive about the new management team. Comments from relatives included “They are terrific, they keep me informed”. People said they found the new managers approachable and had no concerns. Staff said, “I wouldn’t be here if it wasn’t for the managers.”

People told us they were ‘happy’ living at Parc Vro and their care needs were met by caring and skilled staff. Comments included “It’s fantastic here”, “Staff are so good” and “It’s a lovey home.”

Relatives were complimentary about the care their family members received. Comments included “The staff are exemplary, they go above and beyond in all aspects of care for our family member” and “Our relative summed up her feelings for Parc Vro she told us “ I know this is a care home but it feels like my home.”

Safeguarding processes were in place to help safeguard people from abuse. Medicines were safely managed.

There were processes in place to prevent and control infection at the service, through regular COVID-19 testing, additional cleaning and safe visiting precautions.

There were enough staff to meet people's needs and ensure their safety. Appropriate recruitment procedures ensured prospective staff were suitable to work in the service.

Staff told us that they had received the training they needed to meet people’s needs safely and effectively. The training matrix tracked staff training, and this ensured all staff received the training and updates needed to provide safe consistent care.

Staff were supported in their roles through a plan of supervision. Staff told us they felt supported by senior staff and the manager.

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.

The manager had employed an activities coordinator. People were complimentary about the amount of activities on offer and how much they enjoyed them. People told us “There's enough to do here”. People were supported to access activities within and outside the service. The service had developed positive relationships with the local primary-junior school who visited the service.

The management team maintained oversight of complaints, accidents and incidents and safeguarding concerns. The management team engaged well with health and social care professionals.

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

Rating at last inspection.

The last rating for this service was requires improvement (published 19 October 2020) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Parc Vro Residential Home is a care home that provides personal care for up to 15 predominantly older people. On the day of our inspection 12 people were living at the service. The service is a detached two-story building with enclosed gardens that have been used to facilitate relatives visits during the Covid Pandemic.

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

Risks within the service, as a result of peoples’ support needs, had had not been appropriately identified or mitigated. Where accidents and incidents had happened, necessary investigations had not been completed. This meant the service was unable to identify patterns or trends in incidents or take action to prevent reoccurrences.

The service was short staffed at the time of our inspection and the new manager had recently been regularly working as the service’s cook. In addition, we found there were significant variations in staffing levels between weekdays and the weekends. The service’s dependency tool was confusing, and the provider was unable to explain how current staffing arrangements met people’s needs.

Necessary disclosure and barring service checks had been completed prior to the recruitment of staff. However, we have made a recommendation in relation to the service’s systems for establishing people’s previous employment histories.

People felt safe and well cared for and relatives were complimentary of the quality of care the service provided. Comments received included, “Oh yes I am safe here, and happy. That’s why I am smiling. I have nothing to worry about”, “I feel very spoilt living here. They look after me so well” and “I wouldn’t change a thing. I’ve recommended the home to two people who have gone and viewed and agreed with me.”

Medicines were managed safely, and premises were clean and well maintained. Infection control procedures had been updated in line with Covid-19 guidance to help protect people, visitors and staff, from the risk of infection.

Since our last inspection the provider had stepped back from their role in the day to day leadership to the service and a registered manager had been recruited.

At the time of our inspection the registered manager was absent from the service for an extended period and a new interim manager had been appointed. The new manager had received limited induction to their new role and did not fully understand the service’s systems and procedures.

Quality assurance processes were ineffective as they had not identified that care documents did not provide staff with sufficient guidance on the management of risk.

The provider and new manager accepted the initial findings of the inspection and following feedback, immediately began to take action to resolve the issues identified. Risk management and incident investigation processes were reviewed, and guidance sought from the local authority on current best practice.

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

Rating at the last inspection

This service was previously inspected on 3 October 2017 when it was found to be good in all areas.

Why we inspected

We undertook this focused inspection in response to information of concern we had received about staff practices, risk management and the leadership of the service. A decision was made for us to inspect and examine those risks.

Follow up

We will continue to monitor information we receive about the service until we return to check that the issues identified in this report have been resolved. If we receive any concerning information, we may inspect sooner.

Parc Vro is registered to provide residential care for up to 15 older people some of whom were living with dementia. At the time of the inspection there were 13 people living at the service.

The service is situated in a rural area close to the village of St Mawgan near Helston. Parc Vro is a converted house set over two floors. The upper floor was accessed by stairs or a passenger lift. The first floor had various split levels and a stair lift was available for people with mobility problems. There were a range of aids and adaptations suitable to support the needs of people using the service. There was also an external garden area suitable for people to use.

There is no condition for the service to have a registered manager in post. The registered provider had reduced the time they spent at the service, but was available to support the manager in post who had responsibility for the day to day operation of the home and to support staff and operational systems used by the service. 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. The manager was preparing to submit an application for registration with the Commission. People and relatives all described the management of the service as open and approachable.

People and family members all spoke positively about the service. They told us that they or their relative was safe living at the service and that staff were kind, friendly and treated people well. They told us that the manager was always available and approachable. Comments included, “[Relative] has a call alarm system in their room,” and “Yes, I feel very safe living here. I get all the help I need.”

On the day of the inspection visit there was a calm and relaxed atmosphere in the service. We observed people had a good relationship with staff and staff interacted with people in a caring and respectful manner. People told us, “They [staff] are so kind and helpful and considerate” and “All the staff are very caring. It’s a lovely place to live.”

There were sufficient numbers of suitably qualified staff on duty to meet people’s needs. Staff completed a thorough recruitment process to ensure they had the appropriate skills and knowledge.

Safeguarding procedures were in place and staff had a good understanding of how to identify and act on any allegations of abuse.

The manager used effective systems to record and report on, accidents and incidents and take action when required.

Risk assessment were regularly updated and changes made as necessary so staff were responding to current risk levels.

Management and staff had a good understanding of the underlying principles of the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives; the policies and systems in the service supported this practice.

People and their families were given information about how to complain. There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.

The service was generally well maintained and clean. However a ground floor bathroom was cluttered with equipment and the radiator cover outside this room required painting. The manager agreed to address these issues raised at the time of the inspection.

There were no incontinence odours evident. People’s bedrooms were personalised to give them a familiar feel. One person told us they loved the fact they had personal items around them including specific items of furniture and ornaments. Other comments included, “I have some pictures and photos “and “I like to have my things around me, it’s important to me and not a problem at all.”

The way medicines were managed was safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept with appropriate arrangements for storage.

Staff were supported by a system of induction training and supervision. Staff felt well supported by the manager who saw all staff regularly. Staff received training relevant for their role and there were opportunities for on-going training and support and development. The training needs of all staff were being monitored by the manager so updates could be provided when necessary.

People and relatives spoke positively about the food provided by the service. There was sufficient choice and people received appropriate support where required. We observed regular drinks and snacks were offered throughout the day so people received adequate nutrition and hydration. People who lived at the service were all positive about the quality of meals provided. One person said, “I have a good appetite and I like the range and quality of the meals here. Very good.”

People had good access to healthcare professionals and their healthcare needs were being met.

Care plans were well organised and contained accurate and up to date information. People appeared to be well cared for. Care planning was reviewed regularly and people’s changing needs recorded.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise concerns.

Peoples views were taken into account through quality assurance process’s to drive improvement in the service. These included regular audits of the service, surveys and meetings to seek the views of people about the quality of care at the service. Resident meetings were not regularly held formally, although people told us they were often spoken with by the manager and staff members.

We spent time with the registered manager and reviewed the records, policies and procedures in place in order to reach our judgement.

At this inspection we found that people received their prescribed medication at the appropriate times, and the service had appropriate policies and procedures in place to protect people from the risks associated with medicines.

We saw, from the staff files we reviewed, that Parc Vro undertook appropriate checks before staff commenced working at the home.

Peoples' views and experiences had been considered in the way the home was run, and peoples' privacy and dignity was respected.

Peoples' care and treatment met their needs and protected their rights.

We reviewed medication records and saw that the provider did not have appropriate procedures for recording and safe administration of medications for people who lived at the home.

We reviewed the recruitment procedures, and found that appropriate checks were not made before staff commenced working for Parc Vro.

We saw there was an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who lived at Parc Vro.

People told us and we saw evidence of pre-care assessments of peoples' needs to ensure the home could provide the required level of care. The care plans we looked at were sufficiently detailed to direct and inform staff as to how care was to be provided. We saw evidence of regular reviews of care to ensure the care provided took account of any changes that had occurred.

We reviewed people's care records and shared a meal with people who lived at the home over lunch time. The meals were freshly cooked and were of a good standard. We saw that people who used the service were supported to have adequate nutrition and hydration.

We reviewed medication records and saw that the provider was not following appropriate procedures for recording and safe administration of medications for people who lived at the home.

We inspected the premises and assessed that people who used the service and people who worked in or visited the premises were kept safe in accessible surroundings that promoted their wellbeing.