Parkview House

Parkview House is a residential care home which provides accommodation for up to 53 older people who may be living with dementia. The service is provided in one building across two floors with a garden. At the time of inspection 47 people were using the service.

People’s experience of using this service

People were protected from the risks of harm and abuse. Staff were knowledgeable about the actions to take if they suspected somebody was being harmed or abused. People had risk assessments to minimise the risks of harm or abuse they may face. Staff were recruited safely and there were sufficient staff on duty to meet people’s needs. People were protected from the risks associated with the spread of infection. Medicines were managed safely.

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. Staff understood their responsibilities under the Mental Capacity Act (2005).

People’s care needs were assessed before they began to use the service. Staff were supported to carry out their role with training, supervision and appraisals. People were supported with their nutrition, hydration and health. People were supported to meet their healthcare needs.

People, relatives and staff spoke positively about the leadership in the service. Managers and staff understood their role and responsibilities. The provider held regular meetings for people, relatives and staff. The provider had a system of checking the quality of the service provided to identify areas for improvement. The provider worked in partnership with other agencies to improve outcomes for people.

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 requires improvement (published 28 May 2022) 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. This inspection was carried out to also follow up on action we told the provider to take at the last inspection.

Follow up

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

Parkview House is a residential care home providing accommodation and personal care to up to 53 people. The service provides support to older people, some of whom are living with dementia. At the time of our inspection there were 41 people using the service.

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

People were not always treated with dignity and respect by staff. We saw occasions when staff supported people in a way that did not uphold their dignity. Some staff spoke about people and their care in a very task focussed way.

People were not always protected from risk associated with their care needs. We saw poor infection prevention and control practice. Medicines were not managed safely and this meant some people missed medicines because they had run out of stock.

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. Where people’s care plans included restrictions on their liberty, appropriate authorisations had not always been sought. When authorisations were in place the conditions of these authorisations had not been met.

People were at risk of receiving poor quality care because the governance systems were not operating effectively to identify and address issues with the quality and safety of the service.

The provider responded positively when issues with the quality and safety of the service were raised with them.

Relatives told us they thought their family members were safe and felt assured that any issues around potential abuse were escalated appropriately. Staff knew to tell their managers if they had concerns that people were being abused.

There were enough staff on duty. Staff and relatives told us the home had experienced staffing pressures during recent months. The provider had recently completed safe recruitment of new staff. Staff received the training they needed to do their jobs.

People’s needs were assessed using a comprehensive system. However, the resulting care plans lacked personalisation and detail. People’s dietary needs were met, but their preferences were not always recorded. We have made a recommendation about this.

The provider was taking action to improve the premises to ensure they were suitable for people’s needs.

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 3 October 2019)

Why we inspected

We undertook a targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about infection prevention and control measures and whether people’s healthcare needs were being met. A decision was made for us to inspect and examine those risks.

We inspected and found there was a concern with infection prevention and control and ensuring people’s healthcare needs were met so we widened the scope of the inspection to become a focused inspection which included the key questions of safe, effective and well-led.

Enforcement

We have identified breaches in relation to Dignity and Respect, Safe care and treatment, Safeguarding adults and Good governance.

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

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

• The provider followed safe infection prevention and control (IPC) procedures to ensure people, staff and visitors were protected from the risk of infection.

• The provider installed a thermal camera at the entrance of the service to test staff and visitors’ temperatures. This camera also had an additional feature that identified whether staff and visitors were wearing the masks correctly. It alerted the manager where masks were not worn appropriately.

• The provider had appropriate visiting arrangements to ensure people could receive visits safely. Relatives visiting people accessed the booth with a glass window and speaker system specially built for them to interact with people safely. A staff member met relatives outside the main entrance, checked their temperature and provided them with hand sanitiser and masks before escorting them through the side entrance to the booth. This helped to reduce the risk of infection. Where relatives were unable to visit people, staff supported them to stay in touch with their loved ones via video calls.

• People, staff and visitors were supported to follow the government’s guidance on wearing personal protective equipment (PPE) and social distancing.

• The premises were cleaned and disinfected frequently to help prevent the spread of infection. Hygiene stations were put in place throughout the service that were sufficiently stocked with hand sanitisers and PPE. All staff commuted via COVID-19 certified taxis paid by the provider, this further reduced the risk of catching the infection.

• The provider followed the government’s guidance on carrying out COVID-19 testing and made suitable arrangements to test people, staff and visitors.

• All staff received appropriate training and support to prevent and control the spread of infection. Staff only worked on assigned units thereby minimising the risk of cross infection. Staff wellbeing was supported if they became unwell and when they returned to work.

• The manager was well supported by the provider and their COVID-19 lead. They also sought support and advice from external agencies including the Clinical Commissioning Group, the local authority, Public Health England and local health teams to help keep people and staff safe.

Parkview house accommodates up to 53 people of all ages some of whom may be living with dementia, sensory impairment or physical disability. At the time of this inspection, 42 people were using the service. Parkview House is laid out across two floors separated into three different units. People can access the upstairs floor by lift.

People’s experience of using this service

People using the service were protected from avoidable harm. Staff were trained in safeguarding. People had risk assessments and staff knew what actions to take to reduce the risks of harm they may face. There were enough staff on duty to meet people’s needs. The provider had a safe recruitment process. People’s medicines were managed safely and people were protected from the risks associated with the spread of infection.

The provider had systems in place to capture feedback from people about the quality of the service which included recording complaints and compliments. People, relatives and staff had regular meetings so they could be updated on service development. The provider had a system of carrying out regular quality checks to identify areas for improvement. The service worked in partnership with other agencies to provide good outcomes for people.

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 good (published 17 March 2018).

Why we inspected

We received concerns in relation to staffing levels, falls and an increase in bruising. As a result, we undertook a focussed inspection to review the Key Questions of Safe and Well-Led only.

We reviewed the information we held about the service. No areas of concern were identified in the other Key Questions. We therefore did not inspect them. Ratings from previous inspections for those Key Questions were used in calculating the overall rating at this inspection.

We found no evidence during this inspection that people were at risk of harm from the concerns. Please see the Safe and Well-Led sections of this report. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Parkview House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Parkview House accommodates up to 53 people in one adapted building across four separate units. One unit specialises in providing care to people living with dementia. At the time of this inspection there were 38 people using the service because one of the units was in the process of being refurbished. This was the first inspection since a change in provider registration on 25 November 2016.

The service had a manager who was in the process of becoming registered with the Care Quality Commission. 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.

People and relatives felt the service was safe. Staff were knowledgeable about reporting concerns under safeguarding or whistleblowing procedures. People had risk assessments and risk management plans to ensure they received safe care. Building and equipment safety checks were carried out to keep people safe. The provider had medicine management processes in place and was taking advice from an outside agency to improve these processes. The provider ensured infection control measures were implemented to protect people from the spread of infection.

The provider carried out a care needs assessment before a person was admitted to the service to inform the care planning process, The service employed enough suitably qualified staff through safe recruitment procedures to meet people’s needs. Staff received support through training opportunities and supervisions. People had choices of food and received a nutritionally balanced diet according to their needs. The service had effective systems for joint working with healthcare professionals to ensure people’s health needs were met. The provider was aware of their responsibilities under the Mental Capacity Act (2005) and staff were knowledgeable about how to obtain consent.

People and relatives thought staff were caring. Staff were knowledgeable about people’s care needs and communication needs. The provider involved people and relatives in decision making about their care and kept them informed about important events. The manager and staff were aware of how to support people with their relationship needs. People’s privacy, dignity and independence were supported and promoted.

Staff were knowledgeable about providing a personalised care service. Care records contained people’s care preferences. People had access to a variety of activities in accordance with their preferences. The provider had a complaints procedure and dealt with complaints appropriately. Complaints and compliments were used to improve the quality of the service provided.

Staff and relatives spoke positively about the management of the service. The provider encouraged staff to provide high standards of care. People and their relatives were asked to complete a feedback survey so the provider could improve the quality of the service provided. People and relatives also had regular meetings to give feedback to the provider on their satisfaction with the service. Staff had regular meetings to keep them informed about the service development. The provider had various systems of auditing the quality of care provided.

We have made two recommendations around medicines and mealtimes. Further information around this can be found in the detailed findings below.