Park View

Updated 30 November 2019

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 Care Act 2014.

Inspection team

The inspection was undertaken by two inspectors on the first day and one inspector on the second.

Service and service type

Park View is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.

What we did before the inspection

We reviewed information we received about the service from the provider since the last inspection, such as notifications, which the service is legally required to send us. We requested feedback from the local authority and health service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service. We spoke with seven members of staff including the registered manager, deputy manager, one senior support worker, three support workers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and a further two around staff supervision. We reviewed a variety of records relating to the management of the service, including policies and procedures.

After the inspection

We continued to seek clarification from the management team to validate evidence found and actions taken since the inspection. We received feedback from four health and social care professionals and three relatives.

Updated 30 November 2019

About the service

Park View is a residential care home which provides personal care to people with a learning disability or autistic spectrum disorder.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to nine people and nine people were using the service at the time of the inspection. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, or anything else outside to indicate it was a care home. Staff also wore their own clothing to avoid wearing anything that suggested they were care staff when coming and going with people.

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

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles. We discussed with the management team about introducing a plan to demonstrate how they are aiming to reduce the use of restrictive interventions within the service.

Elements of the staff recruitment process had not been robust. There were enough staff to support people and people told us they felt safe living at Park View. Risk assessments were in place for areas of identified risk, but recognised assessment were not always used. Staff were aware of how to support people when they were experiencing periods of distress or anxiety. Professionals fed back that staff knowledge could be further developed in this area. People received their medicines as required and staff understood what actions to take if they thought somebody was at risk of abuse.

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. Staff understood the importance of seeking people’s consent.

We made a recommendation about the application of the Mental Capacity Act, ensuring that capacity assessments were completed when people had restrictions in place.

Staff received training to ensure they had the skills and knowledge to support people. Staff received regular ‘one to ones’ and had annual appraisals of their performance. These aided staff development and practice in how they supported people. The staff team had close links with health and social care professionals and sought their input and advice to help achieve good outcomes for people.

Staff were patient and caring in their approach towards people. People were relaxed with staff and felt confident in asking for their support. Staff were mindful to respect people’s privacy and promote their dignity. People were encouraged and supported to make their own day to day decisions.

Detailed, person-centred care plans were in place which provided clear information about people, their histories and needs. People and their representatives were encouraged to be involved in reviews of their support. Activities were arranged on a group or one to one basis, according to the person’s preferences. Staff understood how people communicated and information was available in a variety of different formats, according to people’s needs.

People, their relatives and staff felt confident to approach the management team with any concerns. The management team were visible and worked alongside staff in supporting people. A series of audits and checks were completed to monitor the quality and safety of the service. People’s feedback was sought to aid in the development of 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

The last rating for this service was good (published 24 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.