Background to this inspection
Updated
22 June 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.
This inspection took place on 30 January and 21 February 2017 and was an unannounced inspection, which meant no-one at the service knew we would be visiting. On 30 January 2017 the inspection team consisted of two adult social care inspectors and an 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. On 21 February 2017 the same two adult social care inspectors continued the inspection.
Before our inspection we reviewed the information we held about the service and the registered provider. This included the service’s inspection history and current registration status and notifications the registered person is required to tell us about. We also reviewed safeguarding information we had received.
We also contacted the local authority contracts and safeguarding team and Healthwatch (Barnsley). Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
During the inspection we spoke with three relatives. We also spoke with the manager, deputy manager, two care staff, the activity co-ordinator, two cooks, a domestic, the administrator, the regional support manager and the regional manager.
We observed care to help us understand the experience of people we could not verbally communicate with, spending time in communal areas and observing how staff interacted with people and supported them.
We spent time looking at records, which included three people’s care records, six staff records and other records relating to the management of the home, such as training records and quality assurance audits and reports.
Updated
22 June 2017
Parklands care home is registered to provide accommodation with residential and nursing care for up to 52 adults, including those living with dementia and mental health needs. The home is located in Wombwell, near Barnsley and situated within grounds shared with two other care homes owned by the same registered provider.
We have inspected this location on two previous occasions and found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This inspection on 30 January and 21 February 2017 was to check improvements had been made to meet the breaches of regulation. The inspection was unannounced. This meant the people who lived at Parklands and the staff who worked there did not know we were coming. We found sufficient improvements had not been made to meet regulations.
There was no registered manager in post at the time of the inspection. 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 a 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 who was running the home at the last inspection had left, a new manager had commenced employment.
Some families expressed they did not always feel their relative was safe at the service because of incidents that happened that had either harmed their relative or others. The number of incidents was supported through notifications submitted to the Care Quality Commission (CQC).
We found staffing levels were sufficient to meet people’s needs, but the recruitment of staff still required improvement to include all the relevant information and documents as required by the regulations.
Systems were in place to manage risks to individuals and the environment, but we found those systems were not always effective in practice to manage the risks identified.
Systems and processes were in place for the safe administration of medicines, but we continued to find the management of medicines required improvement.
There continued to be inconsistency where care plans and risk assessments did not fully reflect a person’s needs, concerns we had raised at previous inspections.
The majority of people received good support and choices at mealtimes, but this was not consistent for everyone who used the service, in particular people receiving their meal from a drinking beaker. For those people there were risks in regard to their nutritional needs, the presentation was not appealing and the people would not have been able to identify individual food by taste.
The premises had been improved to take account of ‘best practice’ in their design for people living with dementia, but further improvement was required. The registered provider had an action plan in place to address this.
Supervision of staff took place, but there was no information to demonstrate staff’s performance had been appraised yearly as stated in the service’s policies and procedures. All training was not up to date, or effective in practice, in particular, fire training.
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. However, we found where decisions had been made in people’s best interest, some decisions lacked evidence to support the person lacked capacity in accordance with the Mental Capacity Act 2005.
People had access to a range of health care professionals to help maintain their health.
There were mixed responses from families about the care their relative received.
There were systems in place to assess and monitor the quality of service provided, but these had not been effective in achieving compliance with regulations.
The local authority and clinical commissioning authority were working with the service to drive the required improvements.
The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’.
Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.
The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.
If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.
This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.
For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.”
Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.