Park House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Medicines were not always managed safely in line with national guidance and best practise. We found a breach of regulation. People were supported to understand safeguarding, and how to raise concerns when they didn’t feel safe. Some staff needed to update their safeguarding training and knowledge in relation to safeguarding. People were supported to manage risk and we saw positive risk taking had been used to help people to develop new skills or maintain their independance. There were sufficient numbers of staff to meet people’s needs and people told us staff always had time to support them. The provider followed their recruitment procedures to ensure people were protected from staff that may not be fit to support them.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People were protected from the risk of potential harm and told us they felt safe and protected. One person said, "I feel safe and happy here."

Some staff lacked knowledge and understanding of safeguarding. For example, some staff could not confirm if they had completed safeguarding training and if the service had a safeguarding policy. One staff member said, "The fire alarms would be reported" when asked about their understanding of safeguarding. Another member of staff told us their understanding of safeguarding was, "To care for and help people be happy." A third staff member commented, "I think there is a policy." In addition, some staff were unaware of what a whistleblowing policy was and how this protected them and people using the service.

Systems and processes were in place to help staff identify and report abuse to help keep people safe. For example, staff received training in safeguarding. However, there were gaps in staff safeguarding training which meant their understanding of what safeguarding was and how to report concerns was not in line with legislation and current best practice.

Staff were aware of people’s risk assessments and felt they could confidently support people safely. Risk assessments accurately reflected people's needs, and the way they preferred to be supported.

We observed staff supporting 1 person to move around the service independently. Staff supporting the person did not take over and supported them to do as much as they could by themself. The staff member was observed respectfully and politely guiding and watching the person safely manoeuvre around the service.

Risks to people had been assessed and their safety monitored. The service helped keep people safe through formal and informal sharing of information about risks. The service used a range of communication techniques including verbal and visual signs to help people understand risks. Risk assessments were detailed and were reviewed and updated swiftly if there had been any changes or incidents. An emergency evacuation plan was in place for each person, to describe the support they would need in the event of a fire or other emergency evacuation of the building. These were up to date and reflective of people's current needs.

Risks to people were managed so they were safe but without restricting their freedom, choice and control. We saw that people were encouraged to take positive risk to maintain their independence. For example, 1 person had been supported to be able to self-medicate when they had started to forget to take their medicines at the right time. A plan was put in place and appropriate support was provided to the person so they could remain independent when taking their medicines.

Staff told us they received training to use equipment, for example, moving and handling equipment. Staff said about the environment that a lot of improvement work had been completed recently. One told us, "The way it looks now is much better than before.”

People told us the environment was safe and met their needs. One person did raise a concern with us about the outdoor space because it was slippery when wet and presented a hazard. We brought this to the attention of the manager who said they would address this.

The environment was safe and suitable to meet people's needs. Equipment was serviced as required and the provider had environmental risk assessments in place. Health and Safety checks were completed regularly, including fire and legionella checks. Clear processes were in place to manage maintenance issues. For example, a call centre logged all jobs and these were prioritised by the housing team. They then arranged a call out to attend and complete the works needed. Larger works, for example, decorating, were approved by senior managers and then planned in for the year.

The service presented clean with no malodour. Corridors and bedrooms were uncluttered and did not present any obvious health and safety risks.

On the day of the assessment, we observed there to be sufficient staff on duty. Staff were seen supporting people when required during mealtimes, activities and with personal care. For example, 1 staff member was seen promptly attending to a person who wanted to access the bathroom. Another member of staff was observed sitting with a person playing a board game and another was observed respectfully supporting a person with their lunch time meal.

The providers supervision matrix evidenced that supervision had been scheduled for the year and there was a supervision policy in place. The dependency tool and the October and November rota's evidenced there was sufficient staff covering shifts that included permanent, bank and agency staff. Safe recruitment practices were in place to ensure only staff suitable to work with vulnerable people were employed.

Staff told us there were sufficient staff to meet people's needs, however some said they had occasionally been short of staff in the past. For example, 1 staff member said, "We have sometimes been short of staff, but its better now." Staff confirmed they received supervision, but they were unclear on the frequency of this. For example, 1 member of staff said, "I've had 2 supervisions in 9 months." Another staff member told us, "I think supervision is every 2 or 3 months."

We observed staff wearing appropriate PPE when serving food at lunch time. Hoists used for moving people were clean and had service stickers in place and we saw these were in date.

Staff confirmed they received infection prevention and control (IPC) training and felt confident to support people with their personal care. We were informed by all staff we spoke with that there was sufficient personal protective equipment (PPE). A senior staff member had been appointed to oversee the IPC processes within the service which meant that necessary IPC systems and checks were more robust. This was evident from a records review where they had been completed consistently since the appointment of the senior staff member.

There were audits in place to monitor the cleanliness of the service. Cleaning charts confirmed areas that were cleaned by the housekeepers which was only for 5 days of the week. Care staff completed the cleaning on the other 2 days but there was no records for this. We raised this with the manager who actioned cleaning records for staff to complete. Clinical waste was disposed of appropriately and PPE was readily avaialble and used appropriately by staff.

People told us staff wore Personal Protective Equipment (PPE) when carrying out personal care. One person said, "They always were them (gloves).” People told us the service was always clean and tidy. One person commented, "The home is spotless.”

Staff confirmed they received medication training and were competency assessed to handle medicines safely.

People did not aways receive their medicines safely or as prescribed. Some people's medicines had run out of stock and some people did not receive their 'as needed' medicines consistently.

People’s medicines records were not always accurate. We found staff members had signed applications of prescribed emollient creams on the Medicine Administration Records (MAR) when other staff members had applied the prescribed creams. This meant records were not always accurate. Records showed that 1 person was prescribed a pain relief medicine and we found this had run out of stock. Staff used the same medicine which was not prescribed but held in stock and administered it. This was not carried out in line with the provider’s policy or best practice guidance. Medication care plans were not always in place or person-centred. This meant the staff may not be able to support people with their health needs effectively. Some people were prescribed medicines to be taken on an 'as needed' (PRN) basis. Guidance in the form of PRN protocols was not always in place to help staff give these medicines consistently. For example, one person who experienced seizures was prescribed rescue medicine to be administered when required. There was no protocol in place for this. For another person who was prescribed a medicine for anxiety, there was no protocol on how staff should try and support the person and not rely on the medicine to alleviate their anxiety. The processes for ordering and management of medicines stock was not always safe. We found that prescribed medicines were not ordered in a timely manner and not all prescribed medicines were in stock. This meant there was a risk that medicines may not be administered as prescribed. Also, we found expired medication for 1 person. There was no record of waste medicines returned to the pharmacy for disposal. Systems had not been effective to ensure people received their medicines safely and consistently. This was a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.