Archived: Parklands House Care Home

We found that robust records were not maintained, evidencing how important decisions had been made to safeguard people from harm or injury and ensure their rights were protected.

Where issues or concerns were identified the provider did not always ensure this was effectively communicated to the relevant authorities so that appropriate action could be taken in a timely manner to help keep people safe.

The manager of the home was not registered with the Care Quality Commission (CQC). An application had been made however had not yet been approved.

Care records did not fully reflect the current and changing needs of people. This meant staff were not clearly directed in the safe delivery of care ensuring people's needs were appropriately met.

Improvements had been made with regards to the auditing and monitoring of the service. The manager was aware further improvements were needed across the service and was working with senior managers to address this.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive to people's needs?

' Is the service well-led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service and their relatives, speaking with the staff supporting them, and from looking at records.

Is the service safe?

Suitable arrangements were not in place for obtaining people's consent to their care and treatment where people lacked the capacity to make decisions for themselves. Where people were potentially being 'deprived of their liberty', the provider had not acted in accordance with legal requirement so that people's rights were protected.

Systems to safeguarding people from the risk of unsafe care were not in place. Events affecting the well-being of people were not adequately recorded or reported so that people were protected.

The management and administration of people's medication was safe.

Recruitment and selection procedures were not robust; necessary to ensure the suitability of applicants before being offered work at the home.

Hygiene standards within the home were poor and did not ensure people were protected against the risk of infection.

People were provided with a choice of suitable and nutritious food and drinks to ensure their nutritional needs were met. More appropriate cutlery and crockery was needed to promote people's dignity and independence.

Is the service effective?

Not enough staff were provided to safely and effectively meet the needs of people.

Arrangements to clearly lead and support the staff team, including agency staff, were not in place. This meant people did not always receive the care and support they needed.

On-going redecoration and refurbishment of the home will ensure people are provided with comfortable, well maintained accommodation.

Is the service caring?

People were not always cared for in a way which maintained their dignity. People looked unkempt and had not been supported in addressing their personal care needs.

Whilst staff were seen to speak with people in a kind and sensitive manner, at times there was little or no communication or activity with people.

Care records contained enough information to show how people were to be supported and cared for. Information included details of people's needs, their life history and their routines.

Is the service responsive to people's needs?

People had access to support in addressing their health needs. Records did not, however, always reflect how peoples changing needs were to be met or if additional health care support had been accessed to minimise the risks to people.

Incidents potentially affecting the well-being of people were not adequately recorded or reported to show that appropriate action had been taken when responding to the changing needs of people.

Is the service well-led?

We were aware there had been no registered manager at the home since June 2013. In this report the name of the registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time. The present manager had made application to registered with Care Quality Commission (CQC).

Systems to monitor and review the quality of care and facilities, as well as opportunities for people to give their views about their experiences were not in place. This information would help to identify where improvements could be made within the home.

Servicing and checks had been completed to the equipment and facilities provided. Action identified to some areas had not been addressed. This puts the health and safety of people living and working at the home at risk of harm.

CQC had not always been notified about notifiable accidents and untoward incidents, as required by legislation. This helps us to monitor events within the home and check that appropriate action has been taken to keep people safe.

Opportunities to enhance people's daily routines were being made. This included the appointment of therapeutic and recreational staff. People's individual needs and preferences were being explored so that social and development opportunities could be offered.

From our observations we found staff to be very attentive and were aware of what care and support people using the service required. It was noted that arrangements in relation to pressure care could be improved so that the risk to people was minimised.

Work to improve the standard of accommodation had started. Completion of the work throughout the home will ensure that people are provided with a good standard of accommodation in which to live. Hygiene standards in some areas of the home also needed improving.

Suitable staffing arrangements were in place. Further recruitment had taken place to fill vacancies for both care, ancillary and therapeutic and recreational staff.

Staff spoke positively about the manager and work carried out since they joined the team at Parklands. Staff spoken with felt supported in their role. One staff member told us, 'His [the manager] focus is very much on improving things for people who live at Parklands'.

Some of the comments received varied about people's experiences. One person living at Parklands told us, 'Yes, it's alright here' and 'The foods good'. However in relation to daily routines they added, 'There's nothing to do' and 'It's boring'. A visitor told us; 'I can visit at any time' and 'my [relative] seems to have settled well'. They added, 'Staff do the basics, clean, dress and help people with their meal but that's it, they are not proactive, need pushing to do things'.

Improvements were found in the individual care records completed when assessing and planning people's care so that staff knew how to meet people's needs.

Suitable arrangements were in place with regards to meeting the nutritional needs of people. Further consideration was needed with regards to how people were supported with their meals to help provide a more sociable activity.

Refurbishment and redecoration of the home was required to improve the standard of accommodation provided.

Suitable arrangements were in place when recruiting new staff. Systems offering on-going training and support for staff had also been developed.

Systems were in place to monitor and review the quality of the service provided.