Western Park View Nursing Home

Western Park View Nursing Home provides personal and nursing care for up to 60 older people. At the time of the inspection there were 50 people in residence. The service was purpose built and has communal rooms and bedrooms on both the ground and first floor.

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

People were at potential risk of the spread of infections. Improvements were needed to the maintenance and systems of practice in the laundry area and auditing of the environment needed to improve to ensure they were robust and effective.

People’s records assessing potential risk were not always completed accurately. The management team had not worked consistently to ensure all staff working within different areas of the service completed records well. We have recommended that the provider implements assessments tools reflective of good practice guidance, which are completed and reviewed by staff who have had training in their use.

The service had a ‘visiting pod’ which would provide independent access for family members to visit their relatives. All visitors to the service would be required to wear personal protective equipment (PPE). Staff were seen to be wearing PPE appropriately. Both people and staff were routinely tested for COVID, consistent with government guidance.

Staff were aware of their responsibilities in reporting concerns to safeguard people. Medication was managed safely. There were enough staff to meet people’s needs and checks were carried out as part of staff recruitment. Staff undertook training in topics related to the promotion of people’s safety, health and welfare. Staff were knowledgeable about their role in reporting concerns, both internally and externally.

People and staff views were sought and were considered as part of managerial meetings to develop the service. The manager had comprehensively responded to whistleblowing concerns and had liaised effectively with staff and with the Care Quality Commission.

Plans for improvement had been identified, these were kept under review by the area manager who regular visited and met with the manager and staff.

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 16 September 2019)

Why we inspected

We received concerns in relation to the quality of care people received due to staff shortages. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only.

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.

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 comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Western Park View Nursing Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to infection control measures to reduce the spread of infection at this inspection.

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

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Western Park View Nursing Home provides residential and nursing care for up to 57 older people. It caters for people with physical and mental health needs. The home was purpose-built and is situated in a residential area of Leicester. At the time of the inspection 51 people were living at the home.

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

People and relatives said the home provided a caring environment for people. A person said, “The staff are wonderful. They care for us beautifully.” A relative said, “The staff have brought me to tears with their care, compassion and kindness.” The staff team was established so people were able to get to know the staff caring for them.

People were safe at the home. Staff knew how to provide safe care and support and reduce risk to people. Staff were safely recruited and fit to work with people who use care services. People had their medicines on time. The home was cleaned to a good standard and was fresh throughout.

People's needs were assessed before they went to the home to ensure staff could meet their needs. Staff were well-trained, skilled and knowledgeable about the people they supported. People were supported to have a balanced and nutritional diet. People praised the food served and said they had plenty of choice at mealtimes.

People’s care and support was personalised and given in line with their preferences. People’s healthcare needs were met by nurses and care workers at the home and visiting healthcare specialists. The home’s activity co-ordinator provided a range of individual and group activities for people.

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 home was a welcoming and friendly place. The acting manager and staff were approachable and kind. People and relatives had a say in how the home was run and said they would recommend it to others. The managers carried out audits to ensure the home was providing good quality care and ongoing improvements were carried out as necessary.

Rating at last inspection

Good (report published 09 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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

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

This inspection took place on 11 and 13 January 2017. The inspection was unannounced on the first day and was carried out by one inspector 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. Our expert for this inspection had experience of the care of older people. They attended for the first day of the inspection.

A registered manager was in place. 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 and associated Regulations about how the service is run.

People using the service and their relatives we spoke with said they thought the home was safe. Staff had been trained in safeguarding (protecting people from abuse) and generally understood their responsibilities in this area.

People's risk assessments provided staff with information of how to support people safely. Staffing levels were sufficient to ensure people were safe. People using the service told us, in the main, they thought medicines were given safely and on time. There were systems in place to ensure that the premises were safe for people to live in.

Staff had been subject to checks to ensure they were appropriate to work with the people who used the service.

Most staff had been trained to ensure they had the skills and knowledge to meet people's needs though more training was needed in specific areas to ensure staff had the skills and knowledge they needed to meet all of people’s assessed needs.

Staff generally understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have an effective choice about how they lived their lives, and the service had obtained legal approval for limiting people's choices when necessary for their best interests.

People had plenty to eat and drink, everyone we spoke with told us they liked the food served and people were assisted to eat when they needed help. People's health care needs were met.

People and their representatives told us that staff were friendly and caring and we saw many examples of staff working with people in a kind and compassionate way.

There was some evidence that people and their representatives were involved in making decisions about their care, treatment and support.

Care plans were individual to the people using the service and covered their health and social care needs. There were sufficient numbers of staff to ensure that people's needs were responded to in good time.

Activities were organised to provide stimulation for people.

People and relatives told us they would tell management or staff if they had any concerns and they were confident they would be followed up.

People, their relatives and staff were satisfied with how the home was run by the registered manager. They all said that this was a well led and well run service.

Not all safeguarding incidents had been reported to CQC as required, which meant we were unaware of all the issues relating to people's safety which prevented a comprehensive risk assessment to see when the service should be inspected.

Management carried out audits and checks to ensure the home was running properly to meet people's needs, though analysis of issues had not always taken place to ensure incidents could be prevented in the future.

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, their relatives, the staff supporting them and looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they felt safe. Two relatives we spoke with also said they thought their relatives were safe in the service.

The service was not completely clean. We found staining to some carpets. This did not fully protect people's dignity. Lighting levels in some areas were dim. They did not protect people from the risk of accidents. We could not see that fire precautions had been properly put into place and reviewed. There was therefore a greater chance of risks to peoples' safety.

We looked at the recruitment of new staff. This showed that required recruitment checks into qualifications and experience were being followed.

We looked at staff training. Not all staff had been trained to meet the needs of people. This put people at risk of being supported by staff without the appropriate skills.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to providing fully effective training and keeping the home safe and clean.

Is the service effective?

People's health and care needs were assessed with them, but they were not always involved in writing their care plans. Some people were not aware of what was in their care plans. Specialist dietary needs were not always included. Care staff had not read all the care plans. Care plans were therefore not able to support staff consistently to meet people's needs.

People's mobility and other needs were taken into account in relation to building adaptation, enabling people to move around freely.

Relatives we spoke with confirmed that they were able to see people in private and that visiting times were flexible.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to people's needs and involving people in planning their care.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People commented, 'staff help me when I need them. I like to be independent and staff respect that'. A relative told us; 'staff are always friendly and welcoming'.

There was no evidence that people using the service, the home's staff and other professionals involved with the service completed an annual satisfaction survey. There were some shortfalls, and some concerns had been raised by relatives. The registered manager was unable to tell us what actions they have taken to address these shortfalls. People were at risk of not having their concerns and needs properly taken into account.

People's preferences, interests, and needs had been recorded. Because of this there was a greater chance that care and support could be provided in accordance with people's wishes.

We asked the provider to tell us what they are going to do to meet the requirements of the law in relation to involving people in planning their care.

Is the service responsive?

We looked at the last discharge from the service where a person had been transferred from another provider's service. Records showed that this had been reasonably well planned and preferences, interests and needs had been included in transfer reports. This means that the service was informed about the person's needs.

We discussed with the manager the lack of dementia friendly facilities regarding the design and layout of the premises, taking account of expert bodies such as the Alzheimer's society.

Is the service well-led?

Staff said that if they witnessed poor practice they would report their concerns.

The service had a quality assurance system to assess and monitor the quality of service provision. The provider had not taken appropriate action to address the shortfalls identified. The system did not ensure that staff were able to provide feedback to their managers, so their knowledge and experience was not being properly taken into account.

There was evidence that the service worked in partnership with key organisations, including the local authority and safeguarding teams, to support care provision and service development.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to quality assurance.

What people told us:

We spoke with 10 people who lived in the home. They all told us that staff were very friendly and always helped them.

We spoke with two relatives. Both stated they had been very satisfied with the service. One relative said; 'staff could not be better. They are all very friendly and caring '.

We carried out a short observational framework inspection. This is an inspection method whereby we sit and observe life in the home to see if people were treated properly and their needs were met. We found that staff were friendly, kind, helpful and caring although more stimulation should have been provided to people to prevent boredom.

There were a number of suggestions: to have more staff, to have frequent residents and relatives meetings, and to have more activities and to provide more meaningful activity to people with dementia.

We observed staff delivering care and support in a patient and efficient manner. People we spoke with told us they trusted the care staff and believed them to be well trained and capable of delivering the care they needed. The provider also took steps to ensure staff maintained their professional skills and displayed a professional approach to their duties.

The provider takes appropriate steps to ensure people's care needs are accurately indentified and fully met whilst they use the service. Members of staff and people using the service told us that they felt supported by the management and were confident any concerns they had would be addressed quickly and satisfactorily.

The provider also ensured all equipment in use by the service and the physical environment were appropriately maintained in order to ensure people using the service were in turn cared for or employed in a suitable and safe environment.