Parkville Care Centre

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

At the lasted rated inspection this key question was rated as good. At this inspection the rating has remained good. This meant overall people were safe and protected from avoidable harm. In the last year there had been an instability in management, and this had led to an increase in staff turnover and a deterioration in practices such as medicine management. Medicine management had not always been effective but action was being taken to resolve these matters. The quality improvement manager had completed a full review of medicine management, checked staff competencies and ensured, when needed, staff received additional training. External professionals reported practices were improving in the service. We found staff understood their role in ensuring medicine was safely administered. Relatives felt people were safe, but some discussed how they felt staff had not always accurately recorded information about people’s health. A new electronic record keeping system had been introduced and the quality improvement manager had been regularly reviewing the entries to make sure they reflected the care and support given. Work was being undertaken to complete a full refurbishment of the home and new maintenance staff had been employed who understood the requirements of their role. They were ensuring all the necessary checks were completed. Staff understood safeguarding procedures and referrals were made as needed. The management team reviewed these and any incidents to determine if there were any themes, lessons that could be learnt and checked that appropriate action was taken. Risks were assessed and action taken to mitigate any risks. People were supported to do the things that were important to them and manage any associated risks. Staff followed appropriate infection control measures. Recruitment practices were meeting requirements. There were enough staff to deliver the care and the provider ensured any vacancies were quickly filled.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives felt the service met their needs. People felt their views were sought about how well their support was being provided and involved in how it was delivered. Relatives did not specifically discuss whether there was a learning culture but most did tell us they were included in discussions, they were able to raise concerns and these were resolved. A relative said, "[Person’s name] is very much treated as an individual rather than just a number there. The new manager is very approachable and is a ' do-er'. If they see things need doing they get them done."

Staff found the new management team consistently reviewed the operation of the service and checked practices were safe. They had critically reviewed the operation of the service and used all information to assist them to understand themes, reasons for the events and lessons, which could be learned. They actively made changes as and when these were needed. For example, they noted more information needed to be provided around how to communicate with people whose first language was not English and reached out to people’s families and the local communities to assist staff improve the communication plans. Staff discussed where the service had been and how they prioritised their work to ensure people were safe and well-cared for first. A staff member said, " It had been a bit rough before the management team stepped in. Now, things have greatly improved, and the new manager is really approachable and I think we are going in the right direction to get back to our previous levels. However, we have always made sure people are looked after well."

Systems were in place to identify any lessons learnt and take appropriate action. Recently there had been an instability in management but with the new registered manager and management team in place this was being addressed. The provider had a quality team and people team who worked with locations to ensure staff could raise matters and areas for improvement could be readily identified and acted upon. The management team could readily identify where gaps existed and acted swiftly to address them. They effectively monitored the quality and safety of the service and ensured people experienced positive outcomes from the support they received. Action plans were used to monitor whether the changes implemented had improved the service. They used all feedback to assist them improve the quality of care. The team ensured any lessons learnt were shared with staff via team meetings, supervision and newsletters.

People told us they felt safe, and they experienced a smooth transition moving in. One person said, “The staff really know what they are doing and always make sure I’m looked after properly.” A relatives said, “I do think [person’s name] is safe at Parkville. [Person’s name] is always clean, their clothing is always clean and her personal hygiene is always just as [person’s name] has always been. They have always been very keen to ensure that that is the case. The carers have also picked up on this and commented on it to me.”

Staff understood when people required support to reduce the risk of avoidable harm, and risk assessments were in place. A staff member said, “I look forward to caring for their residents each day, with a big smile on my face. I am always mentally and physically prepared to handle any task head-on and tackle any challenges as best I can. We make sure residents are supported to be as independent as possible whilst reducing any unnecessary risks.” Care packages were only accepted when staff were confident the person’s needs could be met. The staff ensured care plans contained pertinent information about people’s needs and preferences to enable staff to provide appropriate care. The staff also understood the importance of ensuring continuity of care when people moved to and from the service. Staff ensured they and new worker spent time with people to learn how best to work with them as they transitioned to services.

The service worked in partnership with other agencies to improve people's opportunities and wellbeing.

Systems were in place to ensure people transitioned to the service in a safe manner and there was continuity of care. The provider had introduced an electronic care record system and the management team had ensured care plans contained pertinent information about people’s needs and preferences. Risk assessments were in place and assisted staff readily identify how to mitigate risks.

People reported they were very happy with the service. A relative said, "I do think [person’s name] is safe. I understand that the carers have been told to let me know if they have a fall which has not happened since she moved in there. I have not seen any evidence that she has fallen. When I have visited [person’s name], they seems happy, cheerful and well fed. I never feel I need to worry."

The management team discussed how measures were in place to ensure staff understood when to make safeguarding referrals and how they worked as a team to ensure people were protected from harm. Staff made safeguarding referrals when needed. A staff member said, "I constantly feedback if there are any changes to resident’s health so this can be shared with the GP. I also report any incidents and always make sure residents are kept safe."

People appeared happy with the service. We observed staff worked with people in a sensitive, caring and considerate manner. They encouraged people to be as independent as possible and really encouraged them to reach their full potential. All interactions were conducted in a positive manner.

The provider had safeguarding systems in place. When appropriate staff had made safeguarding alerts to the local authority safeguarding team and sent us the required notifications and reports. Staff said they had training and a good understanding of what to do to make sure people were protected from harm or abuse. Staff said and we saw evidence that they had received safeguarding training.

People told us they had no concerns. A person said, “I can always rely on the safe to keep me right and never had any problems.” A relative said, “I feel [person’s name] is safe there and [person’s name] has said that if they have to be anywhere, Parkville is good and they are happy there. The girls are lovely there and [person’s name] gets on with them. They are nice people there.”

Staff understood when people required support to reduce the risk of avoidable harm. The risk assessments in place were very detailed and effectively assisted staff to safely mitigate risks. A staff member said, “We work closely with the person to find out how best to manage risk and record this in care plans.” Another staff member said, “The care plans really set out what we need to do to support people.”

Our observations raised no concerns about how the service managed risks to people.

Risk assessments were in place and assisted staff readily identify how to mitigate risks. The provider had introduced an electronic care record system, which the quality manager had ensured staff understood how to use and had transferred all the relevant information on to the risk assessments. The management team consistently worked with staff to review people’s needs, identify any changes to their health and well-being and produce additional risk assessments when needed. Risk assessments about care were very detailed, proportionate and effectively assisted staff to safely mitigate risks.

People told us staff had the skills and knowledge to carry out their role effectively and use any equipment safely. People were confident staff could carry out their role safely and competently. Relatives felt the standard of upkeep of the building could be improved. A relative said, “I think it is fine. It could do with a lick of paint in certain places, but the staff are always friendly, happy, smiling people. Whenever I ring the bell to go in, they are always welcoming, chatting and smiling.”

Work was being undertaken to complete a full refurbishment of the home and new maintenance staff had been employed who understood the requirements of their role. They were ensuring all the necessary checks were completed. Staff had received training around adopting safe working practices and following best practices guidance. They felt safe working at the service and had access to all the appropriate equipment they needed.

We observed the building was looking tired and in need of a full refurbishment but work had commenced. Where areas had been redecorated this had been done to a good standard. We saw plans were in place to complete works to the same standard of decoration throughout the whole building.

During the period when there had been instability within the management team areas such as routine maintenance and fire equipment checks had not been completed as often as required. We found the new maintenance staff were proactively addressing these gaps and had prioritised the work. Water temperatures, including those for legionella and fire safety checks had been completed immediately. They had put a programme in place to ensure the required checks were completed each month. The provider had policies in place for the maintaining health and safety within the service. The management team made sure staff had received training to support people who used equipment, such as mobility aides. This included how it was cleaned, calibrated and safe. They understood what risk assessments were needed to make sure staff followed health and safety guidance.

People and relatives found most of the time there were always enough staff on duty. A person said, "I have no complaints as the staff are always around and if I need a hand they come straight away." A relative said, “There always seems to be plenty of staff about. I never have a problem locating any of them.”

Staff reported there were enough care workers to meet people's needs and they work together effectively to provide safe care that meets people’s individual needs. A staff member said, “Sometimes there is not enough staff on duty but that is not because of management it is because of some staff that let their team down. When this does happen [the management team] get it sorted as soon as possible.”

People appeared happy with the service. We observed there were enough staff on duty to meet people’s care and support needs.

Robust and safe recruitment practices were in place, and these made sure staff were suitably experienced, competent and able to carry out their role. Recruitment, disciplinary and capability processes were fair and were reviewed to ensure there was no disadvantage based on any specific protected equality characteristic. We saw evidence confirming when there had been changes to individual’s care and support needs the management team made sure additional staff were available if needed. The staffing levels and skill mix ensured people received consistently safe, good quality care that meets their needs. Staff receive the support and training they needed to deliver safe care. This included supervision, appraisal and support to develop, and improve services and where needed, professional revalidation. Staff received training around all aspects of care including condition specific train and the now required courses around working with people who lived with a learning disability and Autistic people.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

On the whole people and relatives found medicines were managed in a safe manner. A relative said, “Apart from the medication issue, which happened a while back I have had not concerns.”

Medicine management had not always been effective but robust action was being taken to resolve these matters. We found staff understood their role in ensuring medicine was safely administered. Staff were trained in medicines management and processes were in place to assess whether staff were competent to administer people’s medicines.

Overall staff followed best practice when administering medicines and followed STOMP guidance, which meant people’s behaviour was not inappropriately controlled by medicines. Assessments were produced, and these detailed what medication people received. Prior to the new registered manager taking up post the quality manager had, in partnership with external healthcare professionals, identified medicine management practices needed to be improved. Staff were not always maintaining accurate records, following expected practices around administering medicine and ensuring stock control processes were followed. The quality manager had ensured timely action was taken to make the necessary improvements. They had increased the number of checks being completed to ensure medicines had been given as prescribed and records were accurate. Thus, staff were completing daily medicine audits, had completed refresher training and had been assessed as competent. Staff were given clear guidance on when to administer medicines.