This unannounced inspection took place on 20 October 2015 followed by an announced visit on the 21 October 2015. The previous inspection which was undertaken in October 2014 found no breaches of the regulations in force at the time.
Parkvale provides residential care for up to seven people with learning disabilities and/or mental health issues. At the time of our inspection there were seven people living at the service.
The service had 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.
We found some shortfalls in the maintenance of the property mainly in connection with the decoration of the service.
Staff had not protected people from harm by ensuring robust infection control procedures were followed. We found people were not supported to keep their bedrooms clean.
Staff administered people’s medicines proficiently. They had received suitable training to ensure they were able to do this safely. However, we found some shortfalls in the safe management of medicines.
We spoke to all of the people living at the service and all that were asked, said they felt safe.
Staff had an awareness of safeguarding procedures and knew what to do if they suspected any form of abuse occurring. One staff member said, “I have never had to report anything, but would if I had to.”
Accidents and incidents that occurred were recorded and risk assessments completed to minimise the levels of risk to people living at the service. The provider had emergency procedures in place for staff to follow should they find a situation where they needed additional support and information or advice.
Checks had been completed to ensure that the building and the equipment within it was safe to use, including electrical and fire safety equipment.
Care Quality Commission (CQC) is required by law to monitor the operations of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS), and to report on what we find. MCA is a law that protects and supports people who do not have the ability to make their own decisions and to ensure decisions are made in their ‘best interests’. It also ensures unlawful restrictions are not placed on people in care homes and hospitals. In England, the local authority authorises applications to deprive people of their liberty. We found the registered persons were complying with their legal requirements.
People told us, and their care records confirmed, that they had access to healthcare professionals should the need arise. People had visited GP’s, physiotherapists and dentists for example. One person had been referred to a consultant for onward treatment which meant their condition was monitored and appropriately managed.
The service required staff to be available to support people 24 hours every day. We asked people if they thought there was enough staff. They told us they thought there was. One relative said, “They [staff] do what is needed, I think there is enough.” The provider had a system in place to ensure that suitably skilled and appropriate staff were recruited into the service.
Supervision was completed regularly and staff received annual appraisals from their line manager.
The needs of people had been thoroughly assessed and staff regularly completed reviews with them to ensure their care plans remained relevant. People told us they were fully involved in the care planning process. People told us they all had a key worker who helped them with any issues and were there to support them and give some consistency in their lives.
People told us the food was good and they enjoyed what they had to eat and drink. They said they had a wide variety of food, including some food from takeaways if they so wished. We observed meals being prepared in the kitchen, and found it was done with reference to food hygiene procedures. We observed people helping in the preparation of some of the meals.
People were respected and treated with dignity. Staff were considerate and encouraging when providing care and support to people. They supported people to express their views and listened and communicated well with people. It was apparent people got on well with their care workers.
Care plans were in place to guide staff as to how care should be provided and how best to support individuals in their care.
People were independent in the variety of activities they chose to be involved in on a day to day basis. One person chose to fish, while another chose to be involved with football.
People understood how to make a complaint or raise any concerns about their care. The registered manager had checked to make sure people understood how to do this. Documents about making a complaint were available to people who used the service.
People were asked their views on the service and about their care, although this information was not always analysed by the provider, as was the case with recent surveys completed.
The registered manager completed a number of audits and checks but there was little evidence of them being monitored by the provider and we found no appropriate infection control audit being used. Records were limited of the quality assurance visits carried out by the provider’s representative.
We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to premises, medicines and good governance. You can see what action we told the provider to take at the back of the full version of this report.