In this report the name of a 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.Our inspection team was made up of three inspectors and two experts by experience. We gathered evidence against the outcomes we inspected to help answer the five key questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?
We looked at a range of records; spoke with the manager, deputy manager and 19 staff of varying grades and roles including catering and activities staff. We also observed the interactions between staff and people living at Parkville, spoke with 22 people who used the service and nine relatives.
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, and the staff supporting them and from looking at records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People told us that they felt safe and well looked after by staff. We found that staff responded to people's needs and took action when needed when these needs changed. We found staff were confident about the steps they needed to take if they suspected people were at risk of abuse. Procedures for dealing with emergencies were in place and staff were able to describe these to us.
Parkville Care Centre was clean, hygienic and generally well maintained. We did identify that some refurbishment was needed to areas such as bedroom carpets and bathrooms. People had the equipment which they needed. There were effective systems in place for the ongoing maintenance and servicing of equipment.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The home had proper policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. We found that there was some awareness of the process to follow when Deprivations of Liberty Safeguards needed to be considered; however further training was needed and further development to ensure robustness.
People were aware of the complaints procedure and there were systems in place for monitoring complaints.
In the main, there were sufficient staff and skill mix of staff to meet people's needs, however we identified that this needed to be reviewed in respect of the dementia residential unit.
Is it effective?
People all had their needs assessed and had care records, which set out their care needs and associated risks. The care records did not capture all of the information needed in respect of people's needs and were not found to be person centred.
It was clear from our observations and from speaking with staff that they had a good understanding of the people's individual care and support needs and that they knew them well. Some of our observation identified that staff needed more specific training in relation to people's conditions, for example, dementia, which would enable them to deliver more person centred care.
Staff knew how and when to involve other health and social care professionals. We saw lots of evidence of this during our inspection.
Is it caring?
We saw that a number of staff engaged with people in a positive way and showed respect and kindness.
From other observation though we found that some staff were not as engaging as others and we saw them getting on with care tasks as opposed to providing holistic person centred care.
People's needs had been assessed and care plans put in place which detailed people's needs and to some degree preferences. These records provided guidance to staff on what care and support people needed. We found that the care records did not contain sufficient detail of people's life history information. We also found that care records were not as accessible as they should be.
Is it responsive?
There was clear evidence contained within people's care plans to show how they worked with other health and social care professionals.
We saw that care plans were reviewed regularly; however some care plans were not always reflective of people's needs. We could not always see if people and their relatives were involved in their care plans and reviews.
The home employed an activities co-ordinator and were in the process of appointing another co-ordinator. We found that limited activities were available and we could not be sure how meaningful these activities were to people.
People told us that they knew how to make a complaint if they needed to. People we spoke with told us that they felt able to raise a concern if they needed to.
It is well led?
There was a lack of consistency in management between the two buildings and inconsistency in providing person centred and effective care.
The home had a registered manager, who was supported by a deputy manager and also had support from a regional manager and a contracts manager. The manager had been in post for approximately three months and outlined that there was still a lot to be achieved. They acknowledged the lack of leadership within the dementia care unit and were taking steps to address this. They also acknowledged that there was work to do across a number of areas of the home, which they were prioritising.
There were systems in place to assure the quality of the service they provided. The way the service was run was regularly reviewed. Actions were put in place when needed and in the main we were able to see that these actions had been addressed.
People who used the service, their relatives and friends had opportunities to attend regular meetings and also give feedback about the service via annual questionnaires.
Staff were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and were knowledgeable about people's needs. This helped to ensure that people received a good quality service at all times.
We found that appraisals, supervision, staff meetings and some training were not up to date for all staff working at the home. This meant that not all staff were supported to deliver care safely.
What people told us.
People we spoke with in the residential units told us, 'The carers are really nice, pleasant and helpful.' Everyone felt safe in the home and we was told, 'Staff respond quickly if I ring my bell and never complain.'
People were very positive about choice stating, 'I can get up when I want' and 'I love breakfast and had full English this morning with black pudding." Also, 'I can get a drink when I want and only have to ask for whatever I want'. Another resident said she had asked for a newspaper every day and this was delivered for her on a morning.
Quite a few residents said, 'I am encouraged to do little things for myself', and one said, 'I make my bed every day even though I am told I do not have to do it but I try to keep active.'
One relative we spoke with said, 'The girls are lovely ' they do the job'. One lady's husband told us, '"The staff are lovely; 'I'm quite content with her being here.'
Staff we spoke with told us that they enjoyed working at the home. We heard comments such as, 'It's a nice happy environment to work in with nice residents' and 'We all work well together and encourage people to be independent.'