Archived: New Park House

No key question is rated as inadequate and the service is therefore no longer in special measures.

New Park House 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.

New Park House can accommodate 95 people in three units. At the time of the inspection 21 people were using the service, some of whom were living with dementia. Only two of the three units were in use with plans to move into just one unit.

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.’

We could not improve the rating of well-led from requires improvement because to do so requires consistent good practice over time. We will check this during our next planned comprehensive inspection.

Many improvements had been made in the monitoring of the quality of the service however these checks had not always identified when the content and quality of information available to staff required improving.

Notifications were generally submitted as required by the regulations however one incident had not been notified to us, which had been referred to the local safeguarding authority.

People did not always have plans in place to ensure they had their future wishes met at the end of their life.

Further detail was needed to ensure people could effectively communicate if they were not always able to verbally make their needs known.

People were protected from abuse by staff who understood their responsibilities and could recognise different types of abuse.

Risks were assessed and planned for and we saw staff following plans in place to help keep people safe.

People were receiving their medicines as prescribed and robust systems were in place to help identify errors and take appropriate action.

There was a sufficient amount of suitably recruited staff so people did not have to wait long for support. Staff had appropriate training to support people effectively.

Infection control measures were in place to help protect people’s health and wellbeing.

Lessons were being learned as action was taken when concerns were identified to reduce the likelihood of them occurring again.

The principles of the Mental Capacity Act 2005 were being followed. People had their capacity assessed in relation to specific decisions and appropriate best interest decisions were recorded.

People had access to other health professionals and referrals for support were made when someone’s health needs had changed and guidance was followed.

People enjoyed the food and there was a choice. Those with a specialist diet were catered for appropriately.

The building was suitably adapted and people had access to equipment to assist them when needed.

Staff treated people with dignity and respect and we saw caring interactions between staff and people.

People and relatives were involved in decisions about their care where possible.

People had the opportunity to partake in a range of activities and there were further plans to enhance the activities available to people.

Complaints were recorded, investigated and responded to appropriately.

People, relatives and staff felt they could feedback and contribute to the improvement of the home. Meetings were held to encourage feedback.

An action plan was in place to try to ensure continuous improvement and there were more plans to link with organisations to improve the service and quality of care.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

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

New Park House can accommodate 95 people in three units. At the time of the inspection 31 people were using the service, some of who were living with dementia. Only two of the three units were in use.

There was a new manager in post who was yet to register with us. 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's medicines were not always managed and administered safely as advice had not been gained on the safe administration of some medicines and staff did not always have the information they needed to administer medicines safely.

People were not always safeguarded from the risk of abuse as some unexplained injuries had not been investigated or reported to the local authority for further investigation.

Some of the systems the provider had in place to monitor and improve the quality of the service had still not been effective in making the required improvements.

Staff were not always aware of and did not always follow national guidance in delivering care that met people's needs in an effective way.

The provider was not effectively following the principles of the MCA and ensuring that when people lacked the mental capacity to agree to their care they were supported to do so in their best interests.

The building and environment required improvement to meet people's needs in relation to their dementia.

People's right to confidentiality was not always respected and people were not always encouraged to be as independent as they were able.

People's diverse needs and preferences were not always identified to ensure a person centred approach to their care.

People were usually offered activities however a plan was not in place to ensure people remained active in the absence of the activity coordinator.

There were sufficient numbers of staff available to meet people's needs and reduce risks of harm.

Risks of harm to people were minimised and lessons were learned following incidents that had resulted in harm and infection control procedures were followed to prevent the spread of infection.

When people became unwell the appropriate health care support was gained in a timely manner and people were supported to eat and drink sufficient amounts to remain healthy.

People's relatives were free to visit and were involved and kept informed of people's wellbeing and people and their relatives were kept informed of any changes. There was a complaints procedure for people to use if they had concerns.

When accidents and incidents were reported to the manager action was taken to minimise the risk of it happening again.

The provider recognised the needs to improve the quality of care for people and was implementing new systems to bring about the improvements in a timely manner.

Relatives and staff respected the management and felt that improvements had been made.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

New Park House provided nursing and personal care to up to 95 people. At the time of the inspection there were 69 people using the service.

There was a new manager in post who was yet to apply to register with us. 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 were at serious risk of harm as staff were not meeting people's needs in a safe and consistent way. There were insufficient numbers of suitably trained staff to support people with even their basic needs. Risks of harm to people were not being assessed, monitored or minimised as action was not being taken to mitigate the risk following incident and accidents that had resulted or could result in harm to the person.

People were not being safeguarded from the risk of abuse as incidents of potential abuse had not been investigated or referred to the safeguarding authority for further investigation.

People's medicines were not being stored, managed or administered safely. People were at risk of not receiving their medication as it was intended, due to a lack of clear and comprehensive information for staff.

People did not receive health care support in a timely manner when their health care needs changed. Staff did not always follow health care advice to maintain people's health and welfare.

People's nutritional needs were not always met. Some people had insufficient amount of food and drink and this put them at risk of malnutrition and dehydration.

The principles of the Mental Capacity Act 2005 (MCA) were not always followed to ensure that when people lacked mental capacity they were supported by their representative to agree to their care, treatment and support. Some people were at risk of being restricted unlawfully.

Staff were not supported to fulfil their roles effectively and there were not enough staff for them to be able to meet people's needs. Poor staff practise was not always identified and acted upon and this put people at risk of receiving unsafe care.

People were not always treated with dignity and respect and their end of life wishes had not been planned for and acted upon.

People's right to privacy was not always upheld and their independence was not promoted. Some people spent long periods of time in bed without being given the choice or opportunity to get up.

People did not receive care that met their assessed needs and their care records did not reflect their current care needs. Details of people's preferences were not always gained or respected due to a lack of available staff. There were limited opportunities available to a small amount of people to engage in social activities. Other people were at risk of social isolation.

People knew how to complain but their complaints were not always acted upon.

There was a lack of clear leadership and clinical oversight throughout the service. The systems the provider had in place had failed to identify areas for improvement and bring about change. The management had not recognised and responded to failings within the service.

New Park House provides nursing and personal care for up to 95 older people. At the time of this inspection 68 people were using the service.

There were two new managers in post who were yet to register with us. 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.

Risk of harm to people were not always assessed in a timely manner. Individual care plans were not always available to support staff to care for people safely.

There were sufficient numbers of suitably trained staff however, they were not always deployed appropriately to ensure people received a positive meal time experience.

People were not always given choices about how they spent their time and encouraged to be independent. People's individual needs were not always fully assessed or their care needs met.

The management were not ensuring that all people's care needs were being assessed and met.

New staff were being employed through safe recruitment procedures to ensure they were fit and of good character to care for people.

People's medicines were stored, managed and administered in a safe way.

People were safeguarded from the risk of abuse as staff knew what to do and acted when they suspected someone had been the victim of abuse.

The principles of the Mental Capacity Act 2005 were being followed to ensure that people who lacked the mental capacity to consent to their care, treatment and support were being supported to do so in their best interests.

People were being cared for by staff who were supported and trained to fulfil their roles.

People were supported to maintain a healthy diet and they had access to a range of health care professionals if their health needs changed or they became unwell.

People's right to privacy was upheld.

Relatives and friends were free to visit people and were involved in people's care and there were a range of hobbies and entertainment for most people to participate in if they chose. However, people within the nursing unit would have benefitted from more stimulation.

The provider had a complaints procedure and they investigated and acted upon people's concerns.

There had been improvements in the systems and processes to improve the quality of service for people.

Staff felt supported and were involved in making improvements to the way they worked and to the quality of care.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration. For adult social care services the maximum time for being in special measures will usually be no more than 12 months.

New Park House provides nursing and personal care to up to 95 older people. At the time of this inspection 76 people were using the service.

There was a new manager in post who was yet to register with us. 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's medicines were not managed safely. People did not always have their medicines at the prescribed times. Medicine records did not confirm that people had topical creams applied as prescribed. Some cream had run out of stock and some medicine was out of date and ineffective.

Risks of harm to people were not always minimised through the effective use of risk assessments. Staff required training in some areas to be able to care for people safely. People's care records were not always up to date with information to support staff to care for people.

People were not always safeguarded from abuse or the risk of abuse as unexplained injuries were not always reported and investigated.

There were sufficient number of staff deployed throughout the service. They had been recruited using safe recruitment procedures to ensure they were safe to work with people.

The provider was following the principles of the MCA 2005 to ensure that people consented to or were supported to consent to their care, treatment and support.

People's nutritional needs were being met however some people would have benefited from encouragement and support to eat. People had a choice of meals and specialist diets were catered for.

Staff were supported and received training to fulfil their role. However some staff would have benefited from training in how to support people with challenging behaviours.

People's health care needs were met. When people became unwell or their needs changed health care support was gained. People attended health appointments in the community and from visiting health care professionals.

People were offered opportunities to engage in hobbies and activities of their choice. There was a range of entertainment within the service dependent on people's individual needs. The provider had a complaints procedure and people felt they were able to complain if they needed to.

People told us they were treated with dignity and respect, however we observed that people's right to privacy was not always up held.

People told us they respected the management and that they were able to have a say in how the service was run. Improvements had been made since our last inspection however some of the systems the provider had in place to monitor and improve the service were ineffective.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration. For adult social care services the maximum time for being in special measures will usually be no more than 12 months.

New Park House provides nursing and personal care to up to 95 older people. At the time of this inspection 86 people were using the service.

There was a new manager in post who was yet to register with us. 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.

The provider was not protecting people from the risk of harm through neglect as they did not ensure that there were sufficient staff delivering care that were trained and competent. Some staff were delivering care they were not trained to do.

People's medicines were not managed safely. People were not always given the correct dose of their prescribed medicine at the prescribed times and some people had not been administered their medicine as the provider had not ensured sufficient stock was available at all times.

The provider did not consistently follow the principles of the MCA 2005 to ensure that people consented to or were supported to consent to their care, treatment and support.

Systems the provider had in place to monitor and improve the quality of the service were ineffective. Records were inconsistent and disorganised. Audits had not identified the shortfalls in the care being delivered.

People did not always receive care that met their individual needs and preferences .Some people were not engaged or stimulated by activities or their surroundings. Some people sat for long periods of time with no interactions.

People were not always treated with dignity and respect and their right to privacy was not always upheld. People's choices were not always respected as they were not always able to go where they wanted to go when they wanted to.

People's nutritional needs were not always met and health care support was not always gained in a timely manner. People had lost weight and health care advice had not been sought.

There was a complaints procedure and people knew how to use it. People and relatives we spoke with told us that the new manager and staff were kind and approachable.

In addition to following up the previous concern we inspected other aspects of care while we were at the home. We used the services of an expert by experience to help us judge the quality of care.

We saw that people were treated with respect by the staff who cared for them. One person said, "I can't complain. It's very nice here'. Another person said, 'They listen to me and treat me okay'.

We found that care records we checked were personalised and contained assessments and information to enable staff to keep people safe and provide them with appropriate care.

People told us they would tell staff if they were worried or afraid of anything. Staff were trained in adult safeguarding and knew how to support the people they cared for.

As a result of New Park House implementing their action plan we saw that systems were in place to ensure problems were identified, analysed and addressed.

The care that people received had improved. People we spoke with were happy with the care that they received. The care records we viewed showed that the plans of support had improved and they were available for all staff members to access.

The provider had made improvements with the way they managed the medication of people who used the service. Regular checks were carried out to ensure that people were receiving their medication in a safe manner and protected from the risk of harm.

The provider had made improvements to the way they reviewed and audited the care provided to people who used the service. However, there were still some improvements needed to ensure that the care received was monitored and actions that were completed were documented.

The care people received had improved. People were referred for health care support. The care of people with pressure ulcers had improved. People were having their weight checked regularly and actions taken to seek medical advice when there were significant weight changes. Plans were in place to improve the information in plans of care to make them more specific to people and to make them more available to care workers. However there were a large number of plans that still needed to be developed to provide this information.

The provider had made improvements in the way it managed safeguarding incidents. People were better protected because staff were aware of signs of abuse and knew how to act on any concerns they had.

The provider had made improvements to the way it managed people's medication, although further procedures were needed to make sure that people always had their medication as prescribed.

The provider had some systems in place to listen to the views of people and to monitor and review people's care. However some of the systems were not yet fully in place and there remained some areas that were not being fully monitored.