This unannounced inspection took place on 20 and 21 October 2015. At our previous inspection in August 2014 we found the provider was meeting the regulations in relation to the outcomes we inspected.
Parkview is a residential home providing accommodation, care and support for up to 69 people living with dementia. At the time of our inspection the home was providing support to 64 people. A registered manager was not in post at the time of our 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.
At this inspection we found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The service did not have effective processes in place to monitor risks to people because risk assessments were not regularly reviewed, and audits of people’s care plans and risk assessments had not been undertaken in line with the manager’s stated requirements. There were not always sufficient staff available to support people at night, and staff had not always received appropriate refresher training in line with the provider’s requirements. CQC has taken enforcement action to resolve the problems we found in respect of these regulations. You can see the enforcement action we have taken at the back of the full version of this report.
We found a further breach of regulations because risks to people had not always been accurately assessed, and the risks to one person had not been properly managed because a relevant risk assessment relating to their fluid intake was not in place resulting in staff making incorrect assumptions as to why their intake was being monitored. You can see the action we have asked the provider to take at the back of the full version of this report.
There were procedures in place to protect people from the risk of abuse. Staff had received training in safeguarding adults and were aware of the action to be taken if they suspected abuse had occurred. The service undertook appropriate recruitment checks before staff started work and staff were supported in their roles through regular supervision and an annual appraisal.
Medicines were safely stored and recorded, although improvements were required in the overall management of medicines because there were high levels of medicines errors reported during the previous year. The provider had procedures in place to deal with foreseeable emergencies.
Arrangements were in place to ensure people consented to their care, or that decisions about the support they received were made in their best interest and in line with the requirements of the Mental Capacity Act 2005, However some improvement was required in the way people’s consent was documented within their care plans. There were arrangements in place to ensure the service complied with the requirements of the Deprivation of Liberty Safeguards.
People were supported to maintain a balance diet and told us they enjoyed the meals on offer within the home. They had access to a range of healthcare professionals where required and a visiting GP confirmed that staff were proactive in informing them of people’s conditions.
People were involved in decisions relating to their support and their care plans were reflective of their individual needs. However improvements were required in the frequency at which care plans were reviewed, and to demonstrate that people were involved in the reviewing process. A range of activities were available to people within the service which people told us they enjoyed.
The provider had a complaint procedure in place for people to refer to if needed and people we spoke with told us they knew who to raise concerns with if they had any issues.
People told us they were treated with kindness and consideration by staff. Staff were aware of people’s individual needs and preferences and could describe how they worked to ensure people’s privacy and dignity were maintained.
Most people and staff told us they felt the service was well led and the manager had put processes in place to make herself available to staff, people and their relatives when required. The service conducted satisfaction surveys and held regular meetings in order to get people’s views on the home, and feedback was used to drive improvements within the service.