We carried out a review of the data available to us about Parklands Nursing Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Parklands Nursing Home, you can give feedback on this service.
Parklands Nursing Home is a residential care home providing personal and nursing care. The service can support up to 54 people at the time of inspection 51 people were being supported.
People’s experience of using this service and what we found
People and their relatives gave us positive feedback on their experience of using the service. One person said, “I join in activities, and we can have a good laugh.” A relative said, “The staff are all kind and attentive.”
Care and treatment were planned and delivered in a way that was intended to ensure people's safety and welfare. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. Staff had received appropriate training. There were systems in place to minimise the risk of infection and to learn lessons from accidents and incidents. Medicines were dispensed by staff who had received training to do so.
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.
The registered manager had systems in place to monitor the service and improve outcomes for people. Staff were supported to develop their skills and knowledge through training courses. People’s care was planned in a person-centred way to support their independence.
Rating at last inspection and update
The last rating for this service was requires improvement (published 23 February 2021). The registered manager 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 regulation.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Parklands Nursing Home is a residential care home providing personal and nursing care for up to 54 people aged 65 and over. At the time of the inspection there were 50 people living at Parklands Nursing Home, some people may also be living with dementia.
People’s experience of using this service and what we found
Effective arrangements were not in place to mitigate all risks for people using the service or staff employed. Not all appropriate measures were in place or being followed by staff to prevent and control the spread of infections and improvements were required to some aspects of medicines management.
Quality assurance and governance arrangements at the service were not as reliable or effective in identifying shortfalls in the service. Formal safeguarding procedures were not always followed to safeguard people using the service. Lessons were not consistently learned to improve the service.
The deployment of staff was suitable to meet people’s care and support needs and staff recruitment procedures were safe. Proper arrangements were in place to ensure people received their medication as they should. People told us they were safe and liked living at Parklands Nursing Home. Relatives were complimentary about the quality of the service provided. Staff told us they felt supported and valued by the registered manager.
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 2 January 2020).
Why we inspected
The inspection was prompted in part due to concerns received about the management of the service, closed cultures and some aspects of medicines management. 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 coronavirus and other infection outbreaks effectively.
You can see what action we have asked the provider to take at the end of this full report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
People’s experience of using this service and what we found
Staff had a good understanding of safeguarding concerns and how to raise them. Risks to people’s health and wellbeing were identified and managed safely.
The service had not identified some small concerns we found with some equipment. However, they took immediate action to address this and put in place additional measures to mitigate the concerns we found in the future.
People told us they felt safe and relatives told us they had no concerns for their loved ones.
Staff managed medicines safely although we highlighted some improvements to be made and made a recommendation about this.
People were supported to make decisions about the care they received. Staff ensured they always gained consent before care was provided.
Staff were knowledgeable and well trained. Recruitment processes and induction were good.
People were supported to have maximum choice and control of their lives and staff supported support them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People had access to a range of good nutritional food and drinks throughout the day. The meal time experience was very positive.
Staff ensured that people had access to a variety of external health professionals to meet their needs.
Oral hygiene needed to improve, and we made a recommendation about this.
Staff were very caring and supportive. People told us that staff often went the extra mile to ensure they were comfortable and happy.
Care plans were person centred but could be enhanced further and we made a recommendation about this.
People had access to a range of meaningful activities.
People, relatives and staff felt able to raise concerns and were confident these would be dealt with well.
The new manager and deputy manager had worked hard to improve the service and people, relatives and staff told us they were supportive, visible and approachable.
Processes were in place to monitor the quality of care which had significantly improved.
The provider had systems in place to engaged staff, people and relatives in the running of the service. people living there.
Rating at last inspection (and update)
The last rating for this service was Inadequate (published 7 June 2019) and there were multiple breaches of regulation. 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.
This service has been in Special Measures since 7 June 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This was a planned inspection based on the previous rating.
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.
People’s experience of using this service:
People and relatives on the day of inspection spoke positivity about the service, particularly about the caring and compassionate nature of care staff and nurses, and we observed this in care observations.
However, we found that the service was not safe or well led.
Care plans for people with complex needs were not person centred and did not adequately address how staff should manage individual identified risks. This included people at risk of developing pressure ulcers, and those who remained cared for in bed with use of bedrails.
People and staff told us, whilst there were sufficient care staff to meet people’s basic needs, there were not enough nurses. Nursing staff had multiple responsibilities and struggled to complete the required audits and paperwork to ensure that the service provided was safe.
Medicines were not robustly audited to ensure safe practice. People told us that medication administration was not person centred.
Care staff told us they didn’t have time to sit and chat with people in their bedrooms, and some people told us they were lonely and felt isolated and depressed.
The provider did not have a dependency tool, used to calculate the numbers of staff needed to care for people with highly complex needs, the frequent admissions, reviews and various nursing tasks.
The registered manager had not ensured that registered staff and care staff had received appropriate supervision and appraisal to check competency or any concerns staff might have about the service.
The registered manager had poor oversight of the service and did not have robust governance systems in place to ensure the quality of the service. They had not been notifying the appropriate agencies when people were identified at risk or had experienced poor health following incidents and accidents. Information relating to incident and accidents was not used to identify or mitigate future risks.
Rating at last inspection: This service was rated good, with the previous report being published on the 27 June 2017.
Why we inspected: This inspection was brought forward due to information of risk to people following high number of safeguarding alerts.
Enforcement: Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.
Follow up: The service has been placed in special measures. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.
The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.
If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The home had a registered manager in place. 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.
Staff delivered support effectively and care was provided in a way that promoted people’s independence and wellbeing, whilst people’s safety was ensured. Staff were recruited and employed upon completion of appropriate checks as part of a robust recruitment process. Sufficient numbers of staff enabled people’s individual needs to be met adequately. Trained staff dispensed medications and monitored people’s health satisfactorily.
Staff understood their responsibilities and how to keep people safe. People’s rights were also protected because management and staff understood the legal framework of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). We did however note that several staff had not undertaken refresher training in the last two years. In addition, we also found that several staff had not received formal supervision.
The manager and staff ensured access to healthcare services were readily available to people and worked with a range of health professionals, such as social workers, community mental health nurses and GPs to implement care and support plans.
Staff were respectful and compassionate towards people ensuring privacy and dignity was valued. People were supported in a person centred way by staff who understood their roles in relation to encouraging independence whilst mitigating potential risks. People were supported to identify their own interests and pursue them with the assistance of staff. Person centred social activities took place within the service.
Systems were in place to make sure that people’s views were gathered. These included regular meetings, direct interactions with people and questionnaires being distributed to people, relatives and healthcare professionals. The service was assisted to run effectively by the use of quality monitoring audits carried out by the manager and provider, which identified any improvements needed and actions were taken. A complaints procedure was in place and had been implemented appropriately by the management team.
The inspection of Parklands Nursing Home took place on the 19 and 20 November 2014. Parklands is a purpose built nursing home for up to 54 older people who may also have care needs associated with living with dementia.
A registered manager was in post. 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 and associated Regulations about how the service is run.
The CQC monitors the operation of the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) and report on what we find. We saw that there were policies, procedures and information available in relation to the MCA and DoLS to ensure that people who could not make decisions for themselves were protected. The service was applying these safeguards appropriately. This was through assessing people’s capacity and making appropriate referrals to the supervisory body, (the Local Authority,) if people’s liberty was being restricted.
People were happy with the service they were receiving and we received many positive comments about the service and the staff team. We found that people’s health care needs were assessed, and care planned and delivered in a consistent way. Any risks associated with people’s care needs were assessed and plans were in place to minimise the risk as far as possible to keep people safe.
Staff clearly knew how to support people in ways that they wished to be supported. There were sufficient numbers of staff were being provided to meet people’s needs. Staff had the knowledge and skills that they needed to support people. They received training and on-going support to enable them to understand people’s diverse needs.
Staff respected people’s privacy and dignity and worked in ways that demonstrated this. Staff asked for permission before providing any personal care or any activity. The social and daily activities provided suited people and met their individual needs. People were supported to make their own decisions about if they undertook activities or not. People’s preferences had been recorded and we saw that staff respected these.
People were able to complain or raise any concerns if they needed to. Where people had raised issues that these were taken seriously and dealt with appropriately. People could therefore feel confident that any concerns they had would be listened to. The service used a variety of ways to assess the quality and safety of the service that it provided. People using the service and their families were consulted with. The service undertook a range of monitoring and areas such as health and safety and medication were regularly audited. The management team at the service were well established and provided good and consistent leadership.
During our last inspection visit on the 8 January 2014 we found that improvements were required to the service and asked the provider to take actions. This inspection was to look at actions that had been taken and arrangements that are in place.
During our inspection on the 19 May 2014 we spoke with six of the people who used the service and two of their visiting relatives. We also spoke with the provider, manager and nine members of the staff team. We looked at six people's care records, four staff files, training records for staff, safeguarding policy and procedure and the complaints system.
We thought about what we found and asked the questions that we always ask; Is the service safe, effective, caring, responsive and well-led?
This is a summary of what we found:
Is the service safe?
When we arrived at the service we were asked to sign the visitor's book and our identity was checked. This meant that people were protected from unwanted visitors or others who may pose a risk to their safety.
People told us that they felt safe living in Parklands Nursing Home. One person said, 'It is really lovely here, I feel happy and safe here" Another person said, 'I am very happy and I know that I can tell the staff any worries that I might have."
Staff had received training in safeguarding vulnerable adults from abuse (SOVA), the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). This meant that staff had been given the information that they needed to ensure that people were cared for safely.
Is the service effective?
People told us that they felt that the service met their needs. One person who used the service said, 'The staff are very good and so caring, they help me with anything I need.' Another person said, 'The staff are lovely and make sure I have what I need."
People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure their safety and welfare. The care records were well written and had been reviewed and updated monthly. This meant that staff had up to date information about how to meet people's needs.
Is the service caring?
Staff's interaction with people who used the service was good. They spoke with people respectfully and supported them in a kind and caring way. Staff had a good knowledge of people's likes and dislikes. People told us that all of the staff treated them well. One person said, 'The staff are kind and caring.' One person's relatives we spoke to told us, "The staff are very good and very caring. They have cared for [Name of person] very well."
People told us that the staff treated them respectfully. People's preferences and diverse needs had been recorded in their care files and care and support had been provided in accordance with their wishes. This showed that people were cared for by kind and caring staff.
Is the service responsive?
People we spoke with told us that the service had been responsive to their needs. One person told us, "If I want anything changed, I only have to ask and the staff and manager will help me."
People were supported to see other professionals such as a general practitioner, community dentist, chiropodist, optician, and district nurse. This showed that people's general health care needs were met and that the service responded to people's changing needs.
Is the service well-led?
People had been asked for their views and opinions on a daily basis. People told us that they received a good quality service. One person said, 'I get lovely home cooked food, the staff are all very nice and are kind and friendly towards me.' Another said, 'I am very pleased with the service and am very comfortable and happy with my room.' A visiting relative told us, 'I can honestly say that this home is excellent, it is the best service by far. My relative is very happy here and is doing well.'
People who used the service and their relatives told us that the staff and manager asked them for their opinions on the quality of the service. We saw evidence of meetings held with staff, residents and relatives. The complaints procedure was clear and it showed clear timescales of when complaints would be responded to. People told us that they knew how to complain. This showed that there was an effective quality assurance system in place and that the service was well-led.
At the time of the inspection 54 people were living at Parklands Nursing Home. We found that the some of the people who used the service told us they were happy with the care and support provided. However we found that significant improvements were required to ensure that care plans and risk assessments were completed for all areas.
We also found that improvements were needed to ensure people's consent to care and treatment was sought appropriately. Improvements were required for the complaints system and also for supporting staff.
We saw that care was well planned and risks to each person's health, safety and welfare were assessed and actions taken to minimise these risks.
Staff were trained and supported to deliver care and treatment safely and to a good standard. Staff were aware of their responsibilities to keep people safe and to report any poor practices appropriately.
There were efficient measures in place to regularly monitor the quality and safety of the service and to make improvements where needed.
People said that they felt safe whilst living at Parklands Nursing Home and that it is always clean and tidy and that the furniture was of a good quality and that the staff kept it clean. People said that they enjoyed their food and that they usually had plenty of choice. People told us that they were happy to raise any concerns and that they discussed any minor issues at their regular residents meetings.