Archived: Park House

Updated 11 March 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 20 January and 4 February 2016 and was unannounced.

The inspection team consisted of two adult social care inspectors, a specialist advisor who was a registered nurse 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. This expert-by-experience had experience of elderly people with nursing needs and those living with dementia.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We contacted both Wirral local authority quality assurance team and Wirral Healthwatch for their views on the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We also looked at our own records, to see if the service had submitted statutory notifications and to see if other people had made comments to us, about the service.

We talked with four people who lived in the home, six visitors including four relatives and with two health care professionals. We also talked with the registered manager and the provider’s regional manager. We talked with five nursing and support staff, an activities co-ordinator and with the chef.

We looked at 15 care records and eight staff and training records. We pathway tracked three people’s care. We also looked at other records related to the running of the home, such a medication and positional change records, policies, procedures and audits.

One inspector and the expert-by-experience took lunch with some of the people and the inspection team generally observed the care and support throughout the inspection. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

The provider sent us some information immediately after the inspection, such as the training plan and an update on progress.

Updated 11 March 2016

This inspection was unannounced and took place on 20 January and 4 February 2016. At our last inspection in July and August 2016, we had found a number of breaches of legal requirements, relating to dignity and respect, consent to treatment, safeguarding, the numbers of staff provided and failure to follow safe recruitment processes. We made requirement actions for these areas to be improved. We also found further serious concerns and issued warning notices in respect of failure to provide person centred care, safe care and treatment, nutrition and hydration and good governance. We rated the service ‘inadequate’ overall and in all domains and placed it in ‘special measures’.

The provider sent us an action plan and updated us regularly on their progress with their planned improvements. We also received information from the local authority quality monitoring team. At this inspection we found that the service had made significant improvements to the care and support of people and had met the requirement actions and the warning notices. The home has now been taken out of special measures.

One visitor told us, “There has been a massive improvement since the last inspection” and another said, “There have been lots of improvements”.

Park House is a large modern building on three floors, located in a quiet residential area of Birkenhead. It is part of the Four Seasons group of health care services. The home is registered to provide accommodation and care for up to 111 people. The building is split into three units. The ground floor unit is for people who do not require nursing. The middle floor unit is for people with dementia who may require nursing and the top floor unit is for more frail elderly people who may require nursing. At the time of our inspection, there were 80 people living in the home.

The home requires a registered manager. 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.

Since our last inspection, the previous manager had left the service and the provider had recruited two managers, one who was the home manager and the other who was the clinical manager. The home manager had submitted their application to become a registered manager with CQC and was waiting for this to be processed. The clinical manager told us she would also be applying to be similarly registered. During this inspection, the home manager and the regional manager were present.

We found the service to be generally safer and that staff recruitment had been safely completed. The home had recruited more staff and people and visitors had noticed the improvement in care they were able to deliver. Staff knew about abuse and how to prevent and report it. However, we found that the medication recording was not adequate and have made a recommendation about this.

Staff were supervised regularly, but the training needed to be improved and more staff needed to attend key training, such as person centred care. The training records were difficult to follow. The staff followed the principles of the Mental Capacity Act 2005 and we saw that appropriate applications had been made for Deprivation of Liberty Safeguards to the local authority. The home was pleasanter in most areas and was in the process of some refurbishment and the outside areas were tidy.

We found that staff were caring and respected people and their right to privacy. The people living in the home were happy with the care they received. People’s religious and cultural needs were met and staff had been trained in end of life care.

Most people were cared for in a person centred way but records did not reflect that their assessment had considered this. Peoples records were reviewed generally, well, but some review entries were sparse and not informative.

The home was benefitting from having two managers who had split the duties of running the home, between them. Records and auditing had improved but still required more work. The satisfaction with the home had improved and in January 2016, 100% of people who chose to complete a survey, recorded they would recommend it.