Background to this inspection
Updated
21 June 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Our unannounced inspection took place on 24 February 2016 and we returned to give feedback to the registered manager on 26 February 2016. The inspection team consisted of two adult social care inspectors and an expert by experience specialised in care of people living with dementia. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.
We did not ask the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. Before the inspection we reviewed all the information we held about the service, including past inspection reports, action plans and incident notifications sent to us by the provider. We contacted the local authority and Healthwatch to ask if they held any information which would assist our inspection. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. They did not provide any information of concern. We did not send a provider information request before this inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection we spoke with eight people who used the service and two visiting relatives. We also spoke with five staff, the cook, the deputy manager and registered manager. We looked in detail at four people’s care plans, four staff recruitment files and other records relating to the running of the service.
Updated
21 June 2016
Our inspection took place on 24 February and 26 February 2016. The first day was unannounced, and we returned on a second day to give feedback to the registered manager who was not present at the end of the first day.
Parkside Residential Home provides accommodation and nursing care for up to 20 people, and specialises in dementia care. It is situated in a residential area of Leeds close to Roundhay Park and local amenities. At the time of our inspection 13 people were using the service.
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 2008 and associated Regulations about how the service is run.
At our inspection in March 2015 we found the provider was in breach of several regulations of the Health and Social Care Act (Regulated Activities) Regulations 2014. We found the provider was not acting within the provision of the Mental Capacity Act 2005, people did not always receive their medicines as prescribed and people did not always have their hydration and nutritional needs adequately met. We told the provider they needed to take action and we received an action plan. At this inspection we found the provider was still in breach of one of these regulations and identified further breaches.
People who used the service told us they felt safe living at Parkside Residential Home. We saw accidents and incidents were managed well, with updates to people’s care plans as required. Staff understood their responsibilities to report concerns about potential abuse and we saw records which confirmed they received regular training in safeguarding.
Not all windows were fitted with restrictors to limit how far they could open, and we found one window restrictor could be removed by hand. This meant people were at risk of falling from upper floors.
Care plans contained detailed analysis of risks to people and information to enable staff to provide safe care and support.
There was a lack of information in people’s care plans relating to their capacity to make decisions and how they had consented to care.
People told us there were enough staff to provide assistance when it was needed. We saw staffing levels were maintained at a level determined by a dependency calculation. We looked at recruitment records of four staff and saw appropriate background checks were made before staff began working at the service.
People were protected from risks associated with poor infection control because the environment was maintained well. We saw staff cleaning throughout the inspection and found furnishings, bathrooms, toilets and communal areas of the home were clean and free of malodours.
We found care plans contained clear information about the support people needed to have effective nutrition and hydration. Staff we spoke with were knowledgeable about individual needs and how these were met. People who used the service told us they enjoyed the food. We saw people were asked at a residents meeting for suggestions for future menus. We concluded the provider was no longer in breach of regulations relating to nutrition and hydration.
People told us the staff were caring, and we saw the service had an informal atmosphere when we inspected. People said the staff treated them well and with respect, and we observed this during the inspection. Care plans contained information which would assist the staff in developing caring relationships with people.
The provider assessed people to ensure they were able to meet their care and support needs before they began to use the service. This information was used to develop individual care plans which contained clear guidance relating to the person’s needs and how these would be met. We saw evidence care plans were regularly reviewed in conjunction with the person or their relative.
People told us how they spent their time and we saw there was a daily programme of activities on offer.
The provider had a complaints policy in place, and we saw this was displayed in a communal area of the home. There were no records of complaints made since our last inspection, however we did see records of concerns raised by staff and how these had been actioned.
On the day of inspection the current CQC rating for Parkside Residential Home was not on display, and the registered manager told us they did not know this was a requirement.
We found the deputy manager was knowledgeable about people’s care and support needs, and was the main point of contact for people who used the service, their relatives and staff. The registered manager was not engaged with the care and support of people who used the service and did not have a strong leadership presence within the home.
We identified one continuing breach and three further breaches of legislation during this inspection. You can see what action we have told the provider to take at the back of the full version of the report.