Park View Care Home with Nursing

Park View Care Home with Nursing provides residential and nursing care for up to 44 people. Bedrooms are situated over 3 floors, with lift access to all floors. Lounges, a dining room, and a café / bar area are on the ground floor. The home is located in a residential area of South Shor, Blackpool, with easy access to shops and local amenities. There are small gardens to the front and rear of the home, and a car park at the front. At the time of our inspection, 30 people were living at the home.

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

We found the systems in place to manage medicines were unsafe which placed people at risk of harm. Risks to individuals were not managed consistently, which put people at risk of harm. The provider had not ensured staff training was maintained at an appropriate level. Management and oversight of the service was ineffective. There was confusion among staff about roles and responsibilities. The provider’s systems to assess, monitor and improve the quality of the service had not been operated effectively. The provider’s systems for learning from adverse events had not been operated effectively. Records related to people’s care were often inaccurate and incomplete.

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. We have made a recommendation about recording assessments of people’s capacity to make decisions.

The service had systems to protect people from the risk of abuse and improper treatment. Staff were recruited safely, and the premises were clean, tidy and safe. The service made sure people were supported to communicate and planned a variety of activities to enhance people’s wellbeing.

The service met people’s nutritional needs and worked with them to make sure food provision also reflected their preferences. Staff supported people with their healthcare needs and worked well with external healthcare professionals. The premises were maintained and people were able to personalise their bedrooms.

People were treated well, with kindness and compassion by staff who respected their privacy and dignity. The service promoted and staff encouraged people to maintain their independence. There was some inconsistency in the level of person-centred information in people’s plans of care.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 14 July 2022). The service remains rated requires improvement. This service has been rated requires improvement for the last 2 consecutive inspections.

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found the provider remained in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about pressure care, medicines management and staffing. A decision was made for us to inspect and examine those risks.

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.

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

Enforcement and Recommendations

We have identified breaches in relation to medicines management, the management of risk, staff training, governance and quality systems at this inspection.

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

We served warning notices to the provider and registered manager in relation to the breaches of regulation 12 (Safe care and treatment) and Regulation 17 (Good governance).

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good and request an action plan from them. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

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

People’s medicines were not always managed safely, and some care records did not consistently contain accurate information. Audits and checks did not consistently drive improvement.

People told us they felt safe and they were supported by staff who helped them quickly if they needed this. Checks were completed to help ensure prospective staff were suitable to work with people who may be vulnerable. Risk assessments were carried out to help minimise the risk of avoidable harm and staff knew the help and support people needed.

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.

People were cared for in a safe, clean and homely environment by staff who were caring, competent and knowledgeable about people's needs. Staff told us training and supervision was arranged to ensure they had the skills to carry out their role.

Staff told us they felt supported by the registered manager and they were able to approach them if they needed support and guidance. People told us the registered manager was approachable and accessible.

People were consulted and asked their views on the service provided. People told us they were happy at the home and were confident any comments or complaints they made would be listened to.

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

Rating at last inspection The last rating for this service was good (published 17 December 2021).

At our last inspection we recommended the provider reviewed their medicines management processes and the use of their systems for learning from accidents and incidents. At this inspection we found further improvements were required in relation to the safe management of medicines.

Why we inspected

The inspection was prompted in part by notification of a specific incident. We will review this outside of the inspection process. The inspection was also prompted in part due to concerns received about recruitment, medicines, and the safe management of risk. A decision was made for us to inspect and examine those risks. 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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

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

Park View Care Home with Nursing is a residential care home providing personal and nursing care to 35 people at the time of the inspection. The service can support up to 44 people with a variety of needs, including people living with dementia and people receiving care at the end of their lives.

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

We found people’s medicines were not managed safely on the first day of our inspection. The provider acted immediately to make improvements. We have made a recommendation about the management of medicines.

Staff knew people well and ow to support them safely. We have made a recommendation about improving the quality and consistency of records related to people’s care. We have made a recommendation about analysing accidents and incidents to look for areas of improvement. We were assured the service was protecting people against the risk of infection, including COVID-19.

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.

People were cared for by staff who were well supported and had the right skills and knowledge to meet their needs effectively, following good practice guidance. Staff supported people with their healthcare needs and worked well with external healthcare professionals. The service met people’s nutritional needs and worked with them to make sure food provision also reflected their preferences.

People were treated well, with kindness and compassion by staff who respected their privacy and dignity and promoted inclusion. The service supported people to be independent. We received very positive feedback about the caring approach of staff.

The service was led by registered manager who people felt was approachable and caring. People felt the care they received was of a good standard and liked living at the home. The culture was open and inclusive. The registered manager understood their responsibilities and monitored the quality of the service using a range of systems including audits and gaining feedback from people and their relatives. We have made a recommendation about ensuring quality management systems are operated effectively.

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 11 November 2020). At that inspection, we only looked at the safe, effective and well-led key questions. This was the first time the caring and responsive questions had been inspected since the service was registered.

Why we inspected

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.

The inspection was prompted in part due to concerns received about medicines management, risk management and staffing. A decision was made for us to inspect and examine those risks.

Follow up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We were assured during this inspection that there was effective management of the service during this coronavirus pandemic.

We found the following examples of good practice

• The registered manager had comprehensive processes to minimise the risk to people, staff and visitors from catching and spreading infection.

• Staff have received training around the safe use of Personal Protective Equipment (PPE).

• The home had a designated secure unit which was used for isolation of residents with a potential or positive status of coronavirus. There was an area for staff to ensure the correct use of PPE before entering.

• A robust system was in place for staff and other professionals to follow when entering and leaving the building.

• Admissions to the home were completed following Public Health England guidance.

• Social media and electronic tablets were used to communicate with health professionals to promote people’s physical health.

• People’s well-being had been promoted through telephone and video calls. People had access to an external garden area.

• The registered manager was participating in the whole home testing process and had arranged testing for people and staff.

• The unit was covered by a dedicated staff team who provided a support bubble to support all their needs, including their meals and social support.

• Contingency plans were in place should there be a staff shortage. Additional housekeeping and governance tasks had been completed to ensure the home was clean and hygienic.

• The staff had comprehensive knowledge of good practice guidance, the deputy manager told us, “Our priority is always about keeping people safe. Ensuring staff know what they are doing and are working safely is an essential part of that”.

We were assured that this service met good infection prevention and control guidelines as a designated care setting.

Further information is in the detailed findings below.

Park View Care Home with Nursing is a residential care home providing personal and nursing care to 25 older people, who may be living with dementia, at the time of our inspection. The service can support up to 44 people in single bedrooms with sufficient bathing and communal spaces to meet their needs. Park View Care Home with Nursing will be referred to as Park View within this report.

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

The registered manager implemented safer recruitment procedures to employ staff suitable to work with vulnerable people. They enhanced their infection control procedures and had good stocks of Personal Protective Equipment. An employee said, “I also feel safe because there’s lots of equipment and hand sanitiser.” Care files contained personalised risk assessments to guide staff in keeping people safe. Staff had a very good level of expertise in managing medication safely.

Staff had extensive annual face-to-face training. 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. A relative told us, “Staff prevented her from disappearing and brought her back to life because they understood her, made her feel alive and beautiful to see.” Staff assessed and monitored people’s nutritional needs.

The registered manager sought feedback from people and their relatives to check the quality of service delivery. A relative stated, “It’s a world apart from other places I’ve been. I cannot thank them enough.” Staff spoke highly of the registered manager and expressed feeling well-supported. The management team worked closely with other organisations to improve people’s quality of life.

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

Rating at last inspection and update

The service was newly registered on 08 August 2019 and has not yet been awarded a rating. We completed a targeted inspection on 14 and 15 July 2020 to check on a specific concern we received about recruitment processes. There was a breach of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

Follow up

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

Park View Care Home with Nursing is a residential care home providing personal and nursing care to older people and people living with dementia. The service was supporting 24 people at the time of the inspection and is registered to accommodate up to 42 people.

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

Safe recruitment processes were not established and carried out. Pre-employment checks, to ensure staff had the correct skills, knowledge and characteristics for working with vulnerable people, were not always carried out properly. The provider had not ensured they had the required information available about each member of 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 service was newly registered on 08 August 2019 and has not yet been awarded a rating.

Why we inspected

We carried out this targeted inspection to check on a specific concern we received about recruitment processes within the home.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Follow up

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