Park View

Park View is a residential care home providing personal care to up to 23 people. The service provides support to older people, some of whom were living with a dementia. At the time of our inspection there were 23 people using the service.

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

The service was mostly clean. We have made a recommendation that the service takes appropriate measures to address malodours in some areas.

People were safe living in the service. Risk assessments and care plans were in place to guide staff on how to reduce risks to people. Medicines were administered, managed and stored safely.

People told us there were sufficient staff to provide care to them when they required it. People did not have to wait long to have their needs met or receive support with tasks. Staff were recruited safely.

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.

There was a system in place to monitor the quality of the service and identify shortfalls. There was an action plan in place stating what improvements the provider had planned. This included plans to address malodours but we have recommended this action be expedited.

The providers had good oversight of the service and took a hands on approach to overseeing the quality 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

Good (Published 12 September 2017)

Why we inspected

We carried out this inspection to see if the service had made improvements in the ‘safe’ domain, which included improvements to the environment. During this inspection we found that the provider had made the required improvements.

Enforcement and Recommendations

We have made a recommendation that the provider expedites plans to replace flooring to address malodours in some areas of the home.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

There was prominent signage and instructions to explain what everyone should do to ensure safety regarding infection control.

Hand sanitisers and PPE were situated throughout the building. Staff were observed wearing appropriate PPE.

All visitors were screened for symptoms on arrival. Alternative forms of maintaining social contact were used for family and friends when they chose not to visit, for example, keeping in touch using video calls.

The inspection took place on 12 September 2017 and was unannounced

At the previous inspection, the service was rated Good and ‘requires improvement’ in well led. We identified a breach of Regulation 17 – Good governance. At this inspection we found the service retained the good rating overall and had made improvements to the governance of the service.

However at this inspection we rated the ‘Is the service safe?’ domain as Requires improvement. This is because we found some areas of the building required maintenance and adaption to ensure they provided a good quality environment for people living with dementia.

People told us they felt safe. We saw safeguarding procedures were in place and they were followed to help keep people safe. Risks to people’s health and safety were assessed and clear plans of care put in place which were well understood by staff.

Overall, people’s medicines were managed and administered safely although some improvements were needed to some staff practice.

There were enough staff employed to ensure people received a good level of interaction, supervision and companionship. Staff were safely recruited to help ensure they were of suitable character to work with vulnerable people. Staff received a range of training, support and supervision appropriate to their role.

People received a range of food which met their individual needs. Nutritional risks were well managed by the service.

The service was acting within the legal framework of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Where people lacked capacity, best interest processes were followed. People were given choices and involved in decision making to the maximum extent possible.

People’s needs were assessed and clear and person centred plans of care put in place, which were subject to regular review. People said care needs were met and staff were knowledgeable about people. The service worked with a range of professionals to ensure needs were met.

People said staff were kind and caring and treated them well. People were listened to and their views and opinions valued. Systems were in place to listen and respond to people’s complaints.

People and staff spoke positively about the registered manager and said they were approachable. We saw they were hands on and regularly undertook care and support tasks which helped them maintain oversight of the home. Regular audits and checks were undertaken and people’s feedback was used to drive improvements to the service.

We made one recommendation around maintaining and improving the quality of the environment.

Park View provides accommodation for up to 23 people who require help with personal care. Bedrooms are located on two floors with access via a passenger lift. The home overlooks Lister Park in the Heaton area of Bradford. It is close to local amenities and a bus route. Level access is available to the rear of the property and there is a small car park.

At the time of the focused inspection on 14 June 2017 there were 17 people using the service.

There was a registered manager 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.

People told us they felt safe living at Park View and we found staff mostly understood how to keep people safe from harm, but needed some more training in this area. Good systems were in place to make sure people were protected from any financial abuse.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. The legal requirements relating to Deprivation of Liberty Safeguards (DoLS) were being met.

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

Below is a summary of what we found. The summary is based on our observations during

the inspection, discussions with people using the service, the staff supporting them and

our review of records. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

We found staff had a good understanding of safe guarding and different types of abuse. Staff could tell us warning signs they would look out for and who they could report concerns too. Care plans identified risk and risk assessments had been put into place to reduce or remove risk where possible. We found sufficient levels of staff to keep people safe.

Is the service effective?

People had need assessments from joining the service where care plans had been created. Plans were reviewed on a regular basis to make sure they were up to date. Plans included person centred information and we observed staff following people's plans.

Is the service caring?

We observed people were supported by kind attentive staff. We saw that staff showed patience and gave encouragement when supporting people. One person told us, 'Staff are very nice here.' People's preferences, interest and needs had been recorded and care and support had been delivered in line with people's wishes.

Is the service responsive?

We saw people and their families had been involved in care plan reviews. People were aware how to make complaints and staff were aware how to record complaints. Staff told us if they witnessed someone's needs had changed, they would report to the manager and work to update the plan of care. Staff were informed of any changes at handovers or in team meetings.

Is the service well-led?

We saw the service did regular checks on quality of areas such as infection control. The service had recently been inspected by food hygiene and had started making arrangements to achieve their recommendations. Feedback surveys were filled out by people that used the service, staff and relatives. We saw comments and concerns were looked into and changes had been made to improve quality of the service.

We found the environment of the home was clean and there had been changes in how cleanliness was monitored. There was a full time housekeeper who adhered to specific cleaning schedules and this ensured consistency in terms of how processes were managed. We also found the environment had been improved in several areas and maintained to the necessary standards.

We also found staffing levels were sufficient and there were the necessary staff roles to ensure people's needs were consistently met including care staff, housekeeping, cook and registered manager.

We found some aspects of people's needs were met, for example support provided with eating and drinking, and we found staff understood people's key needs. However, with some people, especially those who required most support, some needs were not always fully met such as ensuring people were encouraged to clean their rooms and ensure their clothing was clean.

The care files we reviewed contained accurate information about the needs of people who lived at the home. The care files we reviewed on the first day of the inspection were disorganised and contained unnecessary information. However, the registered manager addressed these issues on our return to the home for the second day of the inspection.

On the first day of the inspection we found the maintenance of the environment of the home and cleanliness to be sub-standard and people were at unnecessary risk of harm through cross infection. Several areas of concern had been rectified by the time we re-visited for the second day of the inspection.

We found staffing levels were inadequate particularly because there was no designated cook or domestic staff. The manager was spending four days a week working in the kitchen and care staff were required to do all the cleaning and manage laundry.

People who lived in the home said the food was "good" or "alright." Comments from the recent satisfaction survey showed the home was a friendly home and staff were terrific and never stopped cleaning the home.