Park Lane House

We found the following examples of good practice.

The service supported people to keep in contact with their family members through visits to the home, phone and video calls.

Staff were adhering to personal protective equipment (PPE) guidance and practices. There was a plentiful supply of PPE close to people’s bedrooms.

The provider had implemented a thorough cleaning schedule. The home was clean and uncluttered.

Park Lane House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Park Lane House is registered to provide nursing, care and accommodation to a maximum of 30 older people, some with a diagnosis of Dementia. At the time of the inspection, there were 23 people living at the home.

There was a registered manager in post, who was present 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People felt safe and were supported by specific risk assessments. Overall, staff were aware of people’s needs and responded to them appropriately. People felt they received their medicines and on the few occasions this didn’t happen audits flagged up any concerns with medicines, which were actively dealt with.

Staff were provided with an induction and training to ensure they were skilled and competent in their role. Staff felt supported, well trained and were confident in approaching the manager for support. People were supported to make choices at mealtimes and drinks and snacks were available throughout the day to help people maintain a healthy weight. People were supported to access a variety of healthcare services in order to maintain good health.

Staff obtained people’s consent prior to offering support. 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.

People received support from staff who they described as kind and caring. Staff treated people with dignity and respect and ensured people were involved in making decisions regarding how they spent their day. Staff treated people with kindness and responded to their needs. Information was available in people’s care records to assist staff to support them.

People and relatives were involved in the planning of their care. Staff were aware of people’s preferences and what was important to them. People were supported to maintain relationships and friendship groups. Staff respected people’s choices and supported people to take part in activities. People had no complaints but were confident that if they raised concerns they would be responded to appropriately.

Audits in place had supported the manager to identify areas for improvement, however the audits carried out had not highlighted all concerns effectively.

The previous ratings from our last inspection were on display.

The service was last inspected on the 28 April 2016 where we found that although the provider was meeting the regulations we assessed associated with the Health and Social Care Act 2008, they were deemed to require improvement. Areas of concern where improvement was required was around staff’s knowledge of people’s needs, the Mental Capacity Act 2005 and how to apply its principals and the language used by staff when communicating with people. We were also not notified of incidents or accidents as required by law. At this inspection we found that some improvements had been made, however some improvements could still be made, in particular around the Mental Capacity Act 2005 and staff’s knowledge of people’s needs.

The manager was registered with us as is required by law. 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 registered manager was available on the day of the inspection visit.

Staff only had a basic understanding of the Mental Capacity Act 2005. Staff were unable to tell us who was deprived of their liberty and why. Staff were not always aware of people’s specific needs and how to give them the care that they required. People were asked for their consent prior to care being carried out. People enjoyed the food and were assisted to eat where required. People’s health needs were addressed and GP and hospital appointments were attended.

Staff did not always maintain people’s privacy and dignity when they were supporting them in the giving of medicines. People’s personal belongings were often misplaced, affecting their quality of life, for instance people were unable to see well without their glasses. People made their own choices where possible and staff encouraged people to retain skills by remaining as independent as possible.

Audits were carried out by the registered manager to assess any patterns or trends and to monitor the quality and safety of the service provided, however they did not always identify concerns. The registered manager had not identified where staff required additional training in order to support people to the best of their ability. People, their relatives and staff spoke positively about the skills of the registered manager. Structures for supervision of staff were in place. The provider gave the registered manager support and visited the home weekly. Notifications were sent to us where required.

People told us that they were kept safe and risk assessments were put in place. Enough staff were on duty to support people with basic requirements. The recording of medicines administered to people was clear and concise and medicines given to people were signed for on a Medicine Administration Record (MAR) sheet.

Systems for updating and reviewing risk assessments and care plans to reflect people’s level of support needs and any potential related risks were effective. People were able to raise any concerns they had and felt confident they would be acted upon.

The manager was registered with us as is required by law. 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 recording of medicines administered to people was clear and concise and medicines given to people were signed for on a Medicine Administration Record (MAR) sheet. A small amount of medicines were missing. People’s health needs were addressed and GP and hospital appointments were attended.

People were asked for their consent prior to care being carried out, but agreements around consent for those who could not communicate or make important decisions was not recorded or signed for. Staff only had a basic understanding of the Mental Capacity Act 2005, however they were aware of people’s specific mental health needs and were able to meet them.

Staff were not always aware of people’s ability to assist themselves and their level of independence and this led to some people not being given assistance when they required it, such as help to eat their food at lunch times.

Staff did not consider people’s dignity when they used inappropriate descriptions of items of equipment. People felt that staff maintained people’s privacy and dignity when they were supporting them.

Enough staff were on duty with the skills, experience and training in order to meet people’s needs. People told us that they were kept safe and that staff interacted with them in a positive manner. People were able to raise any concerns they had and felt confident they would be acted upon.

People, their relatives and staff spoke positively about the approachable nature and leadership skills of the registered manager. Structures for supervision, allowing staff to understand their roles, and responsibilities were in place. The provider gave the registered manager support and visited the home weekly. Audits were carried out by the registered manager to assess that things were being done correctly in the home.

Notifications were not always sent to us as required, so we were not able to see how all incidents had been responded to.

Systems for updating and reviewing risk assessments and care plans to reflect people’s level of support needs and any potential related risks were effective.

People told us they were asked for their consent in respect of daily routines. We saw staff gained consent from people who were not able to express their views through observation of their reactions. One person told us, 'Staff always ask me what I want'.

People and a visitor we spoke with expressed satisfaction with the care and support that staff provided to people. We saw people were provide with care and support as set out in their care plans. One person told us that, 'There's nothing to complain about, I wouldn't be here if there was'.

People told us they had a choice of meals and were happy with the meals that they had. We saw that people who were more dependent were appropriately supported to ensure they had sufficient nutrition and hydration.

We saw that the provider carried out suitable checks to make sure that staff were safe to work with vulnerable adults.

We saw the provider had effective systems to assess and monitor the quality of service.

We spoke with two people and two visitors and they confirmed that they had contributed to, and agreed their, or their representatives care plan. We saw people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People and visitors we spoke with confirmed people's healthcare was promoted.

We saw that the home had appropriate arrangements in place to protect people from the risks associated with medication management. This meant that people were protected from the unsafe use of medication.

Staff received appropriate and ongoing support and supervision from the manager. This meant people were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

We spoke to two visitors who told us the manager holds regular meetings with them to discuss developments and their satisfaction with the service. We saw that the provider took action to address matters people raised in these meetings as well. This meant that people could be confident their views were listened to and acted upon.