Archived: Parkside Residential Home

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.

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, their relatives, the staff supporting them and from looking at records.

Is the service safe?

People told us they felt safe. Safeguarding procedures are robust and staff understood how to safeguard the people they supported.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

Equipment was well maintained and serviced regularly therefore not putting people at unnecessary risk.

Staff had attended several training courses which took into account the needs of the people who used the service. This ensured that people's needs were met.

Is the service effective?

People's health and care needs were assessed where possible with them or their relative. Specialist dietary, mobility and equipment needs had been identified in care plans where required.

Is the service caring?

Care staff were attentive and spent time talking to people and making sure their needs were being met. People commented, 'They are very good to me and I have no complaints' and "I love it here, it's all nice, everybody is lovely, no one is every nasty to me."

People who used the service, their relatives and other professionals involved with the service had completed satisfaction surveys.

Is the service responsive?

People knew how to make a complaint if they were unhappy. People told us they had never needed to make a complaint but if they did they thought that complaints would be investigated and action taken as necessary.

Is the service well led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service had a quality assurance system. Records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continually improving.

When looking around the home we found it to be clean and odour free. We did raise one hygiene concern with a member of staff who immediately rectified the problem.

We looked at how people's medicines were handled on admission to the home. Two people we spoke with confirmed their medicines needs were discussed with them, or their relatives before coming to the home. However, checks were not made with the prescriber to ensure that the home had a complete list of current medicines on admission. Appropriate arrangements were not in place for administering medicines. Arrangements were not in place to ensure that special label instructions such as 'before food' were consistently followed when administering medicines.

During a previous inspection the provider was asked to obtain Criminal Records Bureau (CRB) checks for members of staff. We saw evidence which showed these had been applied for. We also saw that some CRB's had been returned.

The provider had a system in place to identify, assess and manage risks to the welfare of people who used the service and others. We saw care plans were audited including weight charts, pressure care, and falls.

People we spoke with were pleased with the service they were receiving and complimented all the staff that cared for them. One person said, 'We are very well looked after here.'

People were complimentary about the food and said they had more than enough to eat. One relative spoken with said, 'Sometimes when I visit I would have lunch. I find the food very good and see staff helping others to eat.'

People told us they felt safe in the home and were aware of the complaints system. They also told us they were confident any concerns they had would be listened to by the manager and acted upon.

People we spoke with said the home was always clean and warm. One person spoken with said, 'I'm a very cold person, when others think it's very hot I don't think so. They provide me with a small heater so I'm always warm.' We also spoke with a relative of someone who used the service. They said, 'The place is always clean and warm when I come. I have never experience any bad odour at this home.'

People's comments included:

'I have nothing to grumble about, I get all that I need.'

'The staff are always around to help.'

'Staff are kind and polite.'

People looked well cared for and supported and were responded to promptly when they asked for any support or assistance. We saw staff interacting with people in a respectful and caring manner.

People said their rooms were clean and they were happy with the systems in place for their laundry. However, we found the systems in place for the management of infection prevention did not always adequately protect people from the risks of infection.

People who used the service were complimentary about the staff. Their comments included: 'They are all lovely and polite.'

'Staff are very pleasant and well mannered.'

We found that the lack of robust recruitment processes meant that people may be at risk from unsuitable workers.

People said they felt confident to speak to the staff about any concerns they may have. One person said, 'I would speak to any of the girls if I had any concerns.' Another said, 'If I thought things were wrong I would say. I am not one for sitting back and doing nothing.'