Park House

Updated 1 February 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Park House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Park House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This service also provides care and support to people living in their own homes, so that they can live as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for care and support at homes service, this inspection looked at people's personal care and support.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.

During the inspection

We met and spoke with people who used the care home service, however many were not able to tell us about their experience of the care provided. We spoke with 8 members of staff including the nominated individual, registered manager, community care workers, care workers and auxiliary workers. We spoke with and received information from 4 relatives, including a relative whose family member had experience of using the DCA. We received feedback from 9 professionals.

We reviewed a range of records. This included 2 people’s care records and 4 medicines records. A variety of records relating to the management of both services, including policies and procedures were reviewed.

Updated 1 February 2023

About the service

Park House is a ‘care home’ which provides accommodation and personal care for up to 13 people living with dementia and other physical health needs. At the time of the inspection 11 people were using the service.

The service also provides community support (domiciliary care) for people living in their own homes. At the time of the inspection 12 people received support. Support currently provided ranged from individuals receiving 1 or 2 hours a week from one member of staff, to people receiving 4 visits a day from two staff.

The registered manager oversees both services from the care home office. There are 2 separate staff rotas to cover the care home and the domiciliary care team. However, some staff, on duty in the care home, also cover some short visits to people in the community.

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

The environment was safe and there was equipment available to support staff in providing safe care and support. However, the internal environment required updating and attention, with some areas found to be neglected and in a poor state of repair. Carpets were heavily stained and threadbare. Lino in a bathroom had holes in it, making it difficult to clean which posed an infection control risk, and many items of furniture were old and dated. For example, armchairs were badly stained and bedroom furniture was worn and scuffed. We also found many areas of the service were cluttered and untidy. A lounge was being used to dry laundry and a new washing machine had been left in the room and there were several boxes of activity equipment. This meant the room was not a pleasant environment for people to spend their time in. Boxes of equipment were left in many areas of the service. Though unsightly they were not stored in thoroughfares and did not pose a risk to people. The registered manager told us this was due to the lack of storage space available in the service.

Areas of the premises were no longer adequate to meet the needs of the service. Shared lounges and the kitchen area were small, and corridors were narrow which could pose difficulties for people using wheelchairs. A lift was available to upper floors. There was no sluice room in place. Shared bathrooms were outdated.

Council of the Isles of Scilly, who owned the property, have put forward a business case to central government for an integrated building which would include a new care home. They are still waiting for an outcome and decision following a visit from central government. At present money had been made available to upgrade and update the current property and to bring it up to standard. This had not commenced partly due to difficulties identifying a contractor to carry out this work as well as problems associated with the pandemic. One professional commented; “Unfortunately the building is very dated.” A relative said; “The building is very run down. It is very dated and could do with a total revamp or better still be relocated somewhere on the island to a more suitable site that caters for modern day needs.”

Staff for both the care home and DCA were recruited safely, however both the registered manager and nominated individual agreed that they had been struggling to recruit staff on the island. The service used agency workers from the mainland to cover shifts and staff worked extra shifts to cover vacant posts. Limited local housing options meant it was difficult to source accommodation for staff from the mainland, including agency staff which the service was relying on heavily. One relative said; “They do a great job, though have the pressures of staffing and the conditions. Shame they have the pressure of that which can take focus away from what they are doing.” Another said; “Additional funding is needed to help recruitment linked to housing provision for staff.” While a staff member said; “Can be difficult with staffing.” One professional commented; “I’m aware that they were struggling to recruit staff.”

We have made a recommendation about staffing in the report.

Health and safety checks of the environment and equipment were in place. However, we found the audits for checking some areas including weekly room checks, sling checks and daily environment checks were not completed. The registered manager told us that due to staff shortages these had not been completed recently. However, we requested and received updated and completed forms to say these checks had been carried out.

People who were able to, told us they were happy with the care they received, and people said they felt safe living there. One person said; “I’m looked after very well” and a relative said; “She (their relative) is safe with them.” People looked relaxed, happy and comfortable with staff supporting them. Staff were caring and spent time chatting with people as they moved around the service. A professional said; “I have always seen and heard the staff interacting with residents in a most positive, caring manner. They all have a lovely approach, engaging in conversation, while listening and responding to their individual needs.”

A professional said of the care home and the domiciliary care service; “We receive feedback from members of the community about health and care services that they have experienced. We have not received any negative feedback about Park House and the service that they provide.”

Medicines were ordered, stored and disposed of safely within the care home. All medicines were held in individuals’ bedrooms. People who lived in the community received visits from staff to check people had taken their medicines as prescribed.

People were supported by staff who completed an induction, received appropriate training and support to enable them to carry out their role safely, including fire safety and manual handling training. There was time for people to have social interaction and staff carried out activities to assist people. Staff knew how to keep people safe from harm.

Records were accessible and up to date. The service used a computerised care planning system which held records for the care home and for the domiciliary care service. The management and staff knew people well and worked together to help ensure people received a good service.

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 supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately.

Records of people's care were individualised and reflected each person’s needs and preferences. Risks were identified, and staff had guidance to help them support people to reduce the risk of avoidable harm. People’s communication needs were identified, and where they wanted, people had end of life wishes explored and recorded.

Staff told us the registered manager was available, assisted them daily and helped cover shifts when needed. They went onto say how the registered manager was approachable and listened when any concerns or ideas were raised. A staff member said; “Feel very supported (by staff and management) and everyone very friendly.” A professional said; “Particularly I have found the manager of Park House to conduct themselves in a professional, competent, caring manner with genuine desire to care for, support and meet the needs of each and every one of their clients.”

People and their families were provided with information about how to make a complaint and details of the complaint’s procedure were displayed at the service.

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 the service was good, (published 2 October 2018.)

Why we inspected

This inspection was prompted by a review of the information we held about this service and due to receiving information of concern about people’s care.

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.

Enforcement and Recommendations

We have found breaches in relation to the environment and governance.

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

Notice of inspection

This inspection was unannounced.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.